Provider Demographics
NPI:1396087540
Name:MUNZER, KURTIS MATTHEW (DO)
Entity type:Individual
Prefix:DR
First Name:KURTIS
Middle Name:MATTHEW
Last Name:MUNZER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:KURT
Other - Middle Name:MATTHEW
Other - Last Name:MUNZER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:12700 SOUTHFORK RD STE 280
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3287
Mailing Address - Country:US
Mailing Address - Phone:314-892-6565
Mailing Address - Fax:
Practice Address - Street 1:12700 SOUTHFORK RD STE 280
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-3287
Practice Address - Country:US
Practice Address - Phone:314-892-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016017301207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease