Provider Demographics
NPI:1669730073
Name:MEENA RAWAL, D.O.
Entity type:Organization
Organization Name:MEENA RAWAL, D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAWAL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-456-9939
Mailing Address - Street 1:1445 HARRISON AVE NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-2620
Mailing Address - Country:US
Mailing Address - Phone:330-456-9939
Mailing Address - Fax:330-456-3212
Practice Address - Street 1:1445 HARRISON AVE NW
Practice Address - Street 2:SUITE 300
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-2620
Practice Address - Country:US
Practice Address - Phone:330-456-9939
Practice Address - Fax:330-456-3212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
34.008837208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty