Provider Demographics
NPI:1194001669
Name:MUNTEAN HEALTH CARE
Entity Type:Organization
Organization Name:MUNTEAN HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNTEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-592-4229
Mailing Address - Street 1:26 E PARK DR STE 105
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-5003
Mailing Address - Country:US
Mailing Address - Phone:740-592-4229
Mailing Address - Fax:740-592-4010
Practice Address - Street 1:26 E PARK DR STE 105
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-5003
Practice Address - Country:US
Practice Address - Phone:740-592-4229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0062554Medicaid
OH0062554Medicaid