Basic Information
| Provider Information | |||||||||
| NPI: | 1952513988 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MKANDAWIRE | ||||||||
| FirstName: | INAI | ||||||||
| MiddleName: | MEGGIN | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9725 BON HAVEN LN | ||||||||
| Address2: | |||||||||
| City: | OWINGS MILLS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211177410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4844613071 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10085 RED RUN BLVD | ||||||||
| Address2: | SUITE 404 | ||||||||
| City: | OWINGS MILLS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211174836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103637246 | ||||||||
| FaxNumber: | 4103630165 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2007 | ||||||||
| LastUpdateDate: | 04/29/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | H70949 | MD | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.