Provider Demographics
NPI:1720213838
Name:MAINA, NJERI (MD)
Entity Type:Individual
Prefix:DR
First Name:NJERI
Middle Name:
Last Name:MAINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:MAINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:504 BROOKWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6802
Mailing Address - Country:US
Mailing Address - Phone:205-871-9661
Mailing Address - Fax:205-870-1621
Practice Address - Street 1:504 BROOKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209
Practice Address - Country:US
Practice Address - Phone:205-871-9661
Practice Address - Fax:205-870-1621
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL35069207KA0200X, 207K00000X
FLME113021207R00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006107500Medicaid
P10173441OtherRR MEDICARE
FL14L3EOtherBCBS
P10173441OtherRR MEDICARE