| Doctor Name: | DR. MARJORIE EBENEZER |
| NPI Number: | 1336537570 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. MPH |
| License Number: | 35.093334 |
| Business Practice Address: | 877 Pelham Ct Westerville, OH - 430815577 |
| Business Phone Number: | 6148419086 |
| Business Fax Number: | 6148419086 |
| Mailing Address: | 1421 Morse Rd, COLUMBUS |
| State: | OH |
| Postal Code: | 432296423 |
| Phone Number: | 6142625094 |
| Fax Number: | 6142624255 |
| NPI Enumeration Date: | 12/22/2014 |
| NPI Last Update Date: | 12/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 35.093334 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |