Provider Demographics
NPI:1699155234
Name:JENG, JENNIFER MARIA (DO)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIA
Last Name:JENG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 OLENTANGY RIVER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1523
Mailing Address - Country:US
Mailing Address - Phone:614-754-5500
Mailing Address - Fax:614-754-5501
Practice Address - Street 1:6670 PERIMETER DR STE 200
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-8065
Practice Address - Country:US
Practice Address - Phone:614-754-5500
Practice Address - Fax:614-754-5501
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101021873207R00000X
OH34.015294207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine