Provider Demographics
NPI:1649252974
Name:MENIRU, GODWIN I (MD)
Entity type:Individual
Prefix:
First Name:GODWIN
Middle Name:I
Last Name:MENIRU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 EVERHARD ROAD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2408
Mailing Address - Country:US
Mailing Address - Phone:330-497-9400
Mailing Address - Fax:
Practice Address - Street 1:4601 EVERHARD RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2408
Practice Address - Country:US
Practice Address - Phone:330-497-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35080282M207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2401707Medicaid
OH1376559799OtherGROUP NPI
OHME7334841Medicare PIN
OH3600701Medicare PIN
OH2401707Medicaid