Provider Demographics
NPI:1295231652
Name:MUNOZ, DEMETRIO ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:DEMETRIO
Middle Name:ANTONIO
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:550 E GENESEE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-2124
Mailing Address - Country:US
Mailing Address - Phone:315-464-4363
Mailing Address - Fax:315-464-6229
Practice Address - Street 1:550 E GENESEE ST STE 200
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-2124
Practice Address - Country:US
Practice Address - Phone:315-464-4363
Practice Address - Fax:315-464-6229
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306764207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine