Provider Demographics
NPI:1437270279
Name:NYALUGWE, MABALA G (MD)
Entity type:Individual
Prefix:DR
First Name:MABALA
Middle Name:G
Last Name:NYALUGWE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16781 CHAGRIN BLVD # 549
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-3721
Mailing Address - Country:US
Mailing Address - Phone:765-765-8055
Mailing Address - Fax:
Practice Address - Street 1:20050 HARVARD AVE
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-6816
Practice Address - Country:US
Practice Address - Phone:216-291-5151
Practice Address - Fax:216-291-4460
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01043016A207R00000X
OH35.135083207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine