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General NPI Number Information
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NPI Number | 1619080314
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Entity Type | Individual
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Provider Name | MONINA MARTINEZ JAO M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 06/18/2012
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Provider Practice Location Address
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Address Line | 92 N. 4TH ST STE. 29
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City | MARTINS FERRY
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State | OH
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Zip | 43935
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Country | US
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Telephone | 740-633-6741
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Fax | 740-633-6756
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Provider Business Mailing Address
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Address Line | 101 TONI LN
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City | ST. CLAIRSVILLE
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State | OH
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Zip | 43950
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Country | US
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Telephone | 740-695-2215
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Fax | 740-633-6756
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35072287
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License Number State | OH
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