Healthcare Provider Details

I. General information

NPI: 1558358978
Provider Name (Legal Business Name): CAIRNS & MONDARY OB GYN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 12/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 E MARKET ST
WARREN OH
44483-6622
US

IV. Provider business mailing address

1651 E MARKET ST
WARREN OH
44483-6622
US

V. Phone/Fax

Practice location:
  • Phone: 330-394-4900
  • Fax: 330-394-6900
Mailing address:
  • Phone: 330-394-4900
  • Fax: 330-394-6900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35075118M
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35079119
License Number StateOH

VIII. Authorized Official

Name: DR. NATALIE ANN MONDARY
Title or Position: DOCTOR
Credential: MD
Phone: 330-394-4900