Provider Demographics
NPI:1093789257
Name:MUENCH, CARRIE ANN (MD)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:MUENCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14001 RIDGEDALE DR
Mailing Address - Street 2:#100
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1781
Mailing Address - Country:US
Mailing Address - Phone:952-473-0211
Mailing Address - Fax:952-473-7908
Practice Address - Street 1:111 HUNDERTMARK RD
Practice Address - Street 2:#420
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-1459
Practice Address - Country:US
Practice Address - Phone:952-448-3847
Practice Address - Fax:952-448-5083
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43738208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN112152000Medicaid