Provider Demographics
NPI:1366257743
Name:MAMAY, MINAS G
Entity type:Individual
Prefix:
First Name:MINAS
Middle Name:G
Last Name:MAMAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W TICONDEROGA DR APT A
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1387
Mailing Address - Country:US
Mailing Address - Phone:614-974-3694
Mailing Address - Fax:
Practice Address - Street 1:107 W TICONDEROGA DR APT A
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-1387
Practice Address - Country:US
Practice Address - Phone:614-974-3694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)