Provider Demographics
NPI:1255569208
Name:MUNGAI, MAINA N (DO)
Entity type:Individual
Prefix:
First Name:MAINA
Middle Name:N
Last Name:MUNGAI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8054 DARROW RD
Mailing Address - Street 2:BLDG D STE 1
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-2387
Mailing Address - Country:US
Mailing Address - Phone:330-425-1485
Mailing Address - Fax:330-405-7960
Practice Address - Street 1:8054 DARROW RD
Practice Address - Street 2:BLDG D STE 1
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-2387
Practice Address - Country:US
Practice Address - Phone:330-425-1485
Practice Address - Fax:330-405-7960
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34-010621207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0080231Medicaid