Provider Demographics
NPI:1245408525
Name:MUNOZ, OSCAR FERNANDEZ (MD)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:FERNANDEZ
Last Name:MUNOZ
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 1:1002 W NEVILLE ST
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-4324
Mailing Address - Country:US
Mailing Address - Phone:304-255-5363
Mailing Address - Fax:
Practice Address - Street 1:1002 W NEVILLE ST
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-4324
Practice Address - Country:US
Practice Address - Phone:304-255-5363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV11599207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0082773000Medicaid
UPIND49283Medicare UPIN
MU0447154Medicare PIN