Individual
MIRANDA LOU MUNDAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
303 S 4TH ST, DANVILLE, KY 40422-2091
(859) 236-1080
Mailing address
303 S 4TH ST, DANVILLE, KY 40422-2091
(859) 236-1080
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
48854
KY
208000000X
Pediatrics Physician
R3333
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100307540
—
KY
Enumeration date
05/08/2013
Last updated
10/04/2018
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