Provider Demographics
NPI:1033101654
Name:MUONEKE, MAUREEN N (MD)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:N
Last Name:MUONEKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 MAGNOLIA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3332
Mailing Address - Country:US
Mailing Address - Phone:951-735-6969
Mailing Address - Fax:
Practice Address - Street 1:341 MAGNOLIA AVE STE 201
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3332
Practice Address - Country:US
Practice Address - Phone:951-735-6969
Practice Address - Fax:951-735-8560
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058793207V00000X
CAC131881207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD61599203OtherCAREFIRST BLUE SHIELD
MD0001OtherFEP/BLUE CHOICE/ CAPITOL
MD512607000Medicaid
MD512607000Medicaid
MD661FMedicare PIN