Provider Demographics
NPI:1245656685
Name:SILVINO B MUNESES MD PA
Entity type:Organization
Organization Name:SILVINO B MUNESES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SILVINO
Authorized Official - Middle Name:B
Authorized Official - Last Name:MUNESES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-355-1131
Mailing Address - Street 1:10 CHICKORY CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ARM
Mailing Address - State:MD
Mailing Address - Zip Code:21057-9121
Mailing Address - Country:US
Mailing Address - Phone:410-355-1131
Mailing Address - Fax:410-355-4084
Practice Address - Street 1:3721 POTEE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225-1717
Practice Address - Country:US
Practice Address - Phone:410-355-1131
Practice Address - Fax:410-913-4176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0007309207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6281Medicare PIN