Provider Demographics
NPI:1922001320
Name:MUENK, DONALD B (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:B
Last Name:MUENK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29753 HOOVER RD
Mailing Address - Street 2:STE A
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-8900
Mailing Address - Country:US
Mailing Address - Phone:586-573-4333
Mailing Address - Fax:
Practice Address - Street 1:29753 HOOVER RD
Practice Address - Street 2:STE A
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-8900
Practice Address - Country:US
Practice Address - Phone:586-573-4333
Practice Address - Fax:586-573-2149
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301028678207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1805017881OtherBLUE SHIELD OF MICHIGAN
MI3338358Medicaid
MI1805017881OtherBLUE SHIELD OF MICHIGAN
MI3338358Medicaid