Provider Demographics
NPI:1932693264
Name:MAMAI, SEFENESH (NP)
Entity Type:Individual
Prefix:
First Name:SEFENESH
Middle Name:
Last Name:MAMAI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3555 OLENTANGY RIVER RD STE 1080
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3984
Mailing Address - Country:US
Mailing Address - Phone:614-268-8164
Mailing Address - Fax:614-268-8406
Practice Address - Street 1:5775 N MEADOWS DR STE D
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-7300
Practice Address - Country:US
Practice Address - Phone:614-224-4200
Practice Address - Fax:614-224-4207
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH370590163W00000X
OH023038363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse