Provider Demographics
NPI:1851053979
Name:MUNOZ, ERIK PEDRO (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:PEDRO
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:743 MILLER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1813
Mailing Address - Country:US
Mailing Address - Phone:928-777-9600
Mailing Address - Fax:
Practice Address - Street 1:743 MILLER VALLEY RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1813
Practice Address - Country:US
Practice Address - Phone:928-777-9600
Practice Address - Fax:855-449-5560
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ9419363A00000X
PR1107-P.A.363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant