Provider Demographics
NPI:1700844966
Name:MUNZING, DANIEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:E
Last Name:MUNZING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1111 BAKER AVE
Mailing Address - Street 2:GLACIER MEDICAL ASSOCIATES
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2901
Mailing Address - Country:US
Mailing Address - Phone:406-862-2515
Mailing Address - Fax:406-862-4229
Practice Address - Street 1:1111 BAKER AVE
Practice Address - Street 2:GLACIER MEDICAL ASSOCIATES
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2901
Practice Address - Country:US
Practice Address - Phone:406-862-2515
Practice Address - Fax:406-862-4229
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT7180207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000008287OtherMEDICARE PART B GRP ID#
MT0095888Medicaid
MT080036134OtherRAILRAOD MEDICARE PIN#
MT7180OtherMONTANA STATE LICENSE
MT810350909OtherFEIN
MTCI2709OtherRAILROAD MEDIARE GRP ID#
MT000003831OtherBLUE CORSS/SHIELD PIN
MT1104882232OtherGLACIER MEDICAL ASSOC NPI
NE27D0411341OtherCLIA ID#--LAB CERT
MTCI2709OtherRAILROAD MEDIARE GRP ID#
MT1104882232OtherGLACIER MEDICAL ASSOC NPI
MT080036134Medicare PIN