Provider Demographics
NPI:1265632467
Name:MUNOZ, LYNN DAMARIS (MD)
Entity Type:Individual
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First Name:LYNN
Middle Name:DAMARIS
Last Name:MUNOZ
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Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1200 E MICHIGAN AVE
Mailing Address - Street 2:STE 655
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1800
Mailing Address - Country:US
Mailing Address - Phone:517-267-2460
Mailing Address - Fax:517-267-2462
Practice Address - Street 1:SPARROW HOSPITAL - TRAUMA SERVICES
Practice Address - Street 2:1215 E MICHIGAN AVE
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912
Practice Address - Country:US
Practice Address - Phone:517-899-2466
Practice Address - Fax:517-364-3525
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2018-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301090744208600000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1265632467Medicaid