Basic Information
| Provider Information | |||||||||
| NPI: | 1851374615 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JNEIDI | ||||||||
| FirstName: | MUNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6661 CLYO RD | ||||||||
| Address2: | |||||||||
| City: | CENTERVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454592702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9374254000 | ||||||||
| FaxNumber: | 9374254002 | ||||||||
| Practice Location | |||||||||
| Address1: | 4000 MIAMISBURG CENTERVILLE RD | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | MIAMISBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453427615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9378666655 | ||||||||
| FaxNumber: | 9378666595 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/26/2005 | ||||||||
| LastUpdateDate: | 01/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | 35.092005 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 207R00000X | 35.092005 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2472827 | 01 | OH | UNITED HEALTHCARE | OTHER | 000000578348 | 01 | OH | ANTHEM | OTHER | 0565421 | 01 | OH | CIGNA | OTHER | 7028685 | 01 | OH | AETNA | OTHER | 753047296028 | 01 | OH | CARESOURCE | OTHER |