Provider Demographics
NPI:1205840345
Name:RANGINWALA, MUJEEB A (MD)
Entity Type:Individual
Prefix:
First Name:MUJEEB
Middle Name:A
Last Name:RANGINWALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-1227
Mailing Address - Country:US
Mailing Address - Phone:937-525-9350
Mailing Address - Fax:937-525-9343
Practice Address - Street 1:1929 E HIGH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-1227
Practice Address - Country:US
Practice Address - Phone:937-525-9350
Practice Address - Fax:937-525-9343
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35065688207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0240500Medicaid
OHG26349Medicare UPIN
OH0240500Medicaid