Provider Demographics
NPI:1952513988
Name:MKANDAWIRE, INAI MEGGIN (DO)
Entity Type:Individual
Prefix:
First Name:INAI
Middle Name:MEGGIN
Last Name:MKANDAWIRE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9725 BON HAVEN LN
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-7410
Mailing Address - Country:US
Mailing Address - Phone:484-461-3071
Mailing Address - Fax:
Practice Address - Street 1:10085 RED RUN BLVD
Practice Address - Street 2:SUITE 404
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4836
Practice Address - Country:US
Practice Address - Phone:410-363-7246
Practice Address - Fax:410-363-0165
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH70949208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation