Provider Demographics
NPI:1144531864
Name:TEJANI, MONICA VORA (DO)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:VORA
Last Name:TEJANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LONDON AVE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-3570
Mailing Address - Country:US
Mailing Address - Phone:937-578-4346
Mailing Address - Fax:937-578-2370
Practice Address - Street 1:500 LONDON AVE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-3570
Practice Address - Country:US
Practice Address - Phone:937-578-4346
Practice Address - Fax:937-578-2370
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.0116142084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036136079Medicaid
OH0129689Medicaid
OH0129689Medicaid