Provider Demographics
NPI:1477781250
Name:MINJEUR, MONICA MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:MARIE
Last Name:MINJEUR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6911 C AVE NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-1349
Mailing Address - Country:US
Mailing Address - Phone:319-832-1463
Mailing Address - Fax:319-832-1469
Practice Address - Street 1:6911 C AVE NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-1349
Practice Address - Country:US
Practice Address - Phone:319-832-1463
Practice Address - Fax:319-832-1469
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101018300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1477781250Medicaid
IA719260128Medicare PIN