Provider Demographics
NPI:1194879130
Name:TODOROV, MOUNA (MD)
Entity type:Individual
Prefix:
First Name:MOUNA
Middle Name:
Last Name:TODOROV
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MOUNA
Other - Middle Name:
Other - Last Name:EL-SALEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9313 E 34TH ST N
Mailing Address - Street 2:ST 100
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2637
Mailing Address - Country:US
Mailing Address - Phone:316-685-6091
Mailing Address - Fax:
Practice Address - Street 1:9300 E 29TH ST N STE 208
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2183
Practice Address - Country:US
Practice Address - Phone:316-636-5666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-00998207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology