MEDICARE: DR. JOHN JOSEPH NEMUNAITIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RX0202X	Medical Oncology Physician	J3859	TX
2	207RX0202X	Medical Oncology Physician	35.132707	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	8R1513	OTHER	TX	BLUE CROSS OF TEXAS

General Provider Information

NPI Number	:	1164464269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN JOSEPH NEMUNAITIS MD

Provider Business Mailing Address
First Line	:	3355 GLENDALE AVE FL 3
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2426
Country	:	US
Telephone Number	:	419-383-6644
Fax Number	:	419-383-3339

Provider Business Practice Location Address
First Line	:	1325 CONFERENCE DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-8009
Country	:	US
Telephone Number	:	419-383-6644
Fax Number	:	419-383-3339

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	01/22/2018

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