Provider Demographics
NPI:1508820986
Name:MINAI, OMAR A (MD)
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:A
Last Name:MINAI
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 1:602 N 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-2621
Mailing Address - Country:US
Mailing Address - Phone:804-458-7781
Mailing Address - Fax:804-458-7814
Practice Address - Street 1:602 N 6TH AVE
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2621
Practice Address - Country:US
Practice Address - Phone:804-458-7781
Practice Address - Fax:804-458-7814
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070575M207RP1001X
VA0101256013207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2145066Medicaid
OH2145066Medicaid