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Organization

CHARLES O. MBANEFO, MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES O. MBANEFO MD (OWNER)
(216) 368-5687
Entity
Organization

Contact information

Practice address
11201 SHAKER BLVD, SUITE 130, CLEVELAND, OH 44104-3869
(216) 368-5687
(216) 368-5623
Mailing address
11201 SHAKER BLVD, SUITE 130, CLEVELAND, OH 44104-3869
(216) 368-5687
(216) 368-5623

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35-05-1577M
OH

Other

Enumeration date
10/18/2007
Last updated
10/18/2007
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