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Individual
MRS. DOROTHY M MUNCH
Active
Individual
MRS. DOROTHY M MUNCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36720
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000E14668
PREMIER BENEFITS ID #
MO
01
—
164653
BLUE CROSS BLUE SHIELD
MO
01
—
1922003276
NPI NUMBER
MO
05
—
242613073
—
MO
05
—
242613081
—
MO
01
—
26D1003101
CLIA CERTIFICATION NUMBER
MO
01
—
460494181
TAX IDENTIFICATION NUMBER
MO
01
—
915331
UNITED HEALTHCARE ID #
MO
Enumeration date
06/14/2005
Last updated
08/15/2024
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