Provider Demographics
NPI:1952313827
Name:MUNT, EDWIN DAVID (MA)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:DAVID
Last Name:MUNT
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:284 EXECUTIVE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1833
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:110 W WALKER AVE
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-6760
Practice Address - Country:US
Practice Address - Phone:336-633-7000
Practice Address - Fax:336-625-3817
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2022-06-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0667103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical