Provider Demographics
NPI:1306832373
Name:MONDARY, NATALIE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:ANN
Last Name:MONDARY
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 1:1651 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6622
Mailing Address - Country:US
Mailing Address - Phone:330-394-4900
Mailing Address - Fax:330-394-6900
Practice Address - Street 1:1651 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6622
Practice Address - Country:US
Practice Address - Phone:330-394-4900
Practice Address - Fax:330-394-6900
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35075118M207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000285889OtherANTHEM
MO4106131OtherMEDICARE CLASS
OH2412231Medicaid
000000285889OtherANTHEM
P00046785OtherRAILROAD MEDICARE
2412231OtherMEDICAID CLASS
2412231OtherMEDICAID CLASS
OH2412231Medicaid