Healthcare Provider Details

I. General information

NPI: 1851374615
Provider Name (Legal Business Name): MUNA JNEIDI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2005
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6661 CLYO RD
CENTERVILLE OH
45459-2702
US

IV. Provider business mailing address

6661 CLYO RD
CENTERVILLE OH
45459-2702
US

V. Phone/Fax

Practice location:
  • Phone: 374-254-4000
  • Fax: 937-425-4001
Mailing address:
  • Phone: 937-425-4000
  • Fax: 937-425-4002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.092005
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number35.092005
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: