Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Odera Mbanugo, MD

Individual provider Family Medicine Physician · NPI 1053936443

Odera Mbanugo, MD is a Family Practice in Canton, Ohio. Qualified in 2019, 7 years ago. Practices with Aultman North Canton Medical Group, a 49-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
7
Licensed in
OH
In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4320 Cleveland Ave SW
Canton, OH 44707
Phone: (330) 484-2584
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 35.148038 (OH)

Record details

NPI number1053936443
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 11, 2020
Last updated in NPPESJune 9, 2023
Certification dateJune 9, 2023
Mailing addressPo Box 80690, Canton, OH 44708-0690

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Aultman North Canton Medical Group — 49 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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