Provider Demographics
NPI:1669250460
Name:MUNN, CAHIL D (IDMT)
Entity type:Individual
Prefix:
First Name:CAHIL
Middle Name:D
Last Name:MUNN
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5955 WISTERIA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-4411
Mailing Address - Country:US
Mailing Address - Phone:435-849-6665
Mailing Address - Fax:
Practice Address - Street 1:5955 WISTERIA DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-4411
Practice Address - Country:US
Practice Address - Phone:435-849-6665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians