Provider Demographics
NPI:1407188212
Name:JOHN F MUNROE MD, PA
Entity Type:Organization
Organization Name:JOHN F MUNROE MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MUNROE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-642-2230
Mailing Address - Street 1:PO BOX 790
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-0790
Mailing Address - Country:US
Mailing Address - Phone:910-641-0400
Mailing Address - Fax:910-642-5929
Practice Address - Street 1:619 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-3707
Practice Address - Country:US
Practice Address - Phone:910-642-2230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2262207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8961375Medicaid
NC61375OtherBCBS OF NC
NC8961375Medicaid
NCC80517Medicare UPIN