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Organization
DOROTHY M. MUNCH, D.O., LLC
Active
Organization
DOROTHY M. MUNCH, D.O., LLC
Active
Other names
Poplar Bluff Wellness Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAULA J MCALISTER BSHA/LTC (ADMINISTRATOR)
(573) 778-1697
Entity
Organization
Contact information
Practice address
930 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-4242
(573) 778-1620
(573) 778-1486
Mailing address
930 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-4242
(573) 778-1620
(573) 778-1486
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
MO
01
—
164653
BLUE CROSS BLUE SHIELD
MO
01
—
1922003276
INDIVIDUAL NPI
MO
05
—
242613073
—
MO
05
—
242613084
—
MO
01
—
26D1003101
CLIA
MO
01
—
915331
UNITED HEALTH CARE
—
01
—
P00109903
MEDICARE RAILROAD
MO
Enumeration date
09/09/2008
Last updated
09/09/2008
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