Provider Demographics
NPI:1922005883
Name:MUNGER, CRAIG E (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:E
Last Name:MUNGER
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 1:6329 GALL BLVD
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-2515
Mailing Address - Country:US
Mailing Address - Phone:813-788-7616
Mailing Address - Fax:813-783-2856
Practice Address - Street 1:6329 GALL BLVD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-2515
Practice Address - Country:US
Practice Address - Phone:813-788-7616
Practice Address - Fax:813-783-2856
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071209207W00000X
FLME71209207WX0109X, 207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31542OtherBCBS FLORIDA
NY0498746OtherGHI
FL250497900Medicaid
FL0805199OtherUNITED HEALTHCARE
FL2074404OtherAETNA
FL5127315OtherAETNA
FL250497900Medicaid
FL2074404OtherAETNA
FL5127315OtherAETNA
FL31542BMedicare PIN