# MRS. DOROTHY M MUNCH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1922003276
- **Gender:** F
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 36720 | MO | Yes |

## Other

- **Enumeration date:** 06/14/2005
- **Last updated:** 08/15/2024

## 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 |