Provider Demographics
NPI:1003883893
Name:MUNSON, WILLIAM A (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:MUNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E FONTANERO ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-7533
Mailing Address - Country:US
Mailing Address - Phone:719-636-3829
Mailing Address - Fax:719-636-1387
Practice Address - Street 1:325 E FONTANERO ST
Practice Address - Street 2:COLORADO SPRINGS ENDOCRINE CLINIC PC
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-7533
Practice Address - Country:US
Practice Address - Phone:719-636-3829
Practice Address - Fax:719-636-1387
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14847207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01148477Medicaid
D22734Medicare UPIN
F7418Medicare ID - Type Unspecified