Provider Demographics
NPI:1851374615
Name:JNEIDI, MUNA (MD)
Entity type:Individual
Prefix:DR
First Name:MUNA
Middle Name:
Last Name:JNEIDI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6661 CLYO RD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-2702
Mailing Address - Country:US
Mailing Address - Phone:937-425-4000
Mailing Address - Fax:937-425-4002
Practice Address - Street 1:6661 CLYO RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-2702
Practice Address - Country:US
Practice Address - Phone:374-254-4000
Practice Address - Fax:937-425-4001
Is Sole Proprietor?:No
Enumeration Date:2005-11-26
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.092005207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0565421OtherCIGNA
OH7028685OtherAETNA
OH2472827OtherUNITED HEALTHCARE
OH753047296028OtherCARESOURCE
OH2948930Medicaid
OH000000578348OtherANTHEM
OH2472827OtherUNITED HEALTHCARE
OH7028685OtherAETNA