Provider Demographics
NPI:1851374615
Name:JNEIDI, MUNA (MD)
Entity Type:Individual
Prefix:DR
First Name:MUNA
Middle Name:
Last Name:JNEIDI
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 1:6661 CLYO RD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-2702
Mailing Address - Country:US
Mailing Address - Phone:937-425-4000
Mailing Address - Fax:937-425-4002
Practice Address - Street 1:4000 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-7615
Practice Address - Country:US
Practice Address - Phone:937-866-6655
Practice Address - Fax:937-866-6595
Is Sole Proprietor?:No
Enumeration Date:2005-11-26
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.092005207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2472827OtherUNITED HEALTHCARE
OH000000578348OtherANTHEM
OH0565421OtherCIGNA
OH7028685OtherAETNA
OH753047296028OtherCARESOURCE
OH4245952Medicare PIN
OH2472827OtherUNITED HEALTHCARE
OH7028685OtherAETNA