Provider Demographics
NPI:1619107091
Name:MUNFUS-MCCRAY, DELICIA L (MD)
Entity Type:Individual
Prefix:
First Name:DELICIA
Middle Name:L
Last Name:MUNFUS-MCCRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10024 HARPOON CIR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-0932
Mailing Address - Country:US
Mailing Address - Phone:205-276-8106
Mailing Address - Fax:
Practice Address - Street 1:3059 S MARYLAND PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2294
Practice Address - Country:US
Practice Address - Phone:702-432-3441
Practice Address - Fax:732-732-2310
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15304207ZP0102X
AZ49182207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology