Provider Demographics
NPI:1164495321
Name:MUNIR, MUHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:MUNIR
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:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:205 E LAUREL BLVD
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901
Practice Address - Country:US
Practice Address - Phone:570-622-1887
Practice Address - Fax:570-622-1959
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032997L207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0473231OtherUS HEALTHCARE
PA116993900OtherFEDERAL EMPLOYEES COMP
PA110031027OtherRAILROAD MEDICARE PBA
PA01159701OtherKEYSTONE
PA10766OtherGEISINGER HEALTH PLAN
PA0000005121OtherBLUE SHIELD
PA0998130OtherKEYSTONE SPECIALIST
PA0006505980001Medicaid
PA020301000OtherFEDERAL BLACK LUNG
PA50047344OtherCAPITAL BLUE CROSS
PA0998130OtherKEYSTONE SPECIALIST
PAB95891Medicare UPIN