Provider Demographics
NPI:1851324644
Name:HENRIQUES, RENA MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:RENA
Middle Name:MICHELLE
Last Name:HENRIQUES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5150 E DUBLIN GRANVILLE RD STE 210
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43081-7023
Practice Address - Country:US
Practice Address - Phone:614-788-9370
Practice Address - Fax:614-788-9409
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077838207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2288653Medicaid
OHHE4066623Medicare PIN