Provider Demographics
NPI:1740210806
Name:MINGIONE, MATTHEW J (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:MINGIONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1299 OLENTANGY RIVER RD
Mailing Address - Street 2:STE. 103
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3118
Mailing Address - Country:US
Mailing Address - Phone:614-566-4278
Mailing Address - Fax:614-566-5424
Practice Address - Street 1:3555 OLENTANGY RIVER RD
Practice Address - Street 2:STE. 3030
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3912
Practice Address - Country:US
Practice Address - Phone:614-566-4378
Practice Address - Fax:614-566-6904
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35089313207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2723440Medicaid
OHMI4209771Medicare PIN