Provider Demographics
NPI:1255409686
Name:MENDEZ MUNOZ, ANDRES R (MD)
Entity type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:R
Last Name:MENDEZ MUNOZ
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 1:500 W ANNANDALE RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4205
Mailing Address - Country:US
Mailing Address - Phone:703-521-6662
Mailing Address - Fax:
Practice Address - Street 1:500 W ANNANDALE RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4205
Practice Address - Country:US
Practice Address - Phone:703-521-6662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2023-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD56516207R00000X
DCMD32022207R00000X
VA0101230282207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
006957M92Medicare ID - Type Unspecified
H34271Medicare UPIN