Provider Demographics
NPI:1518997873
Name:MUNK, CHRISTIAN (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:MUNK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 TRENIER DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-9730
Mailing Address - Country:US
Mailing Address - Phone:702-208-0866
Mailing Address - Fax:702-420-2534
Practice Address - Street 1:1510 W HORIZON RIDGE PKWY STE 140
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-3502
Practice Address - Country:US
Practice Address - Phone:702-878-0070
Practice Address - Fax:702-818-1928
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229045207L00000X
AZ4572207L00000X
NVDO1372207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1518997873Medicaid
NV1518997873Medicaid
AZ347461Medicare PIN
NVVAR570ZMedicare PIN