Provider Demographics
NPI:1255432027
Name:MUNOZ, CESAR E (MD)
Entity type:Individual
Prefix:DR
First Name:CESAR
Middle Name:E
Last Name: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 1:840 PASSOVER RD
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-2834
Mailing Address - Country:US
Mailing Address - Phone:573-302-0319
Mailing Address - Fax:573-693-1680
Practice Address - Street 1:840 PASSOVER RD
Practice Address - Street 2:
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065-2834
Practice Address - Country:US
Practice Address - Phone:573-302-0319
Practice Address - Fax:573-693-1680
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL157092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009913174Medicaid
AL92368Medicare UPIN
AL009913174Medicaid