Individual
IAN W MUNGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDHS
Contact information
Practice address
43401 N JEFFERSON AVE, SELFRIDGE, MI 48045-5266
(586) 239-4971
Mailing address
1837 W STATE BLVD, FORT WAYNE, IN 46808-1933
(419) 670-4790
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
12/11/2025
Last updated
12/11/2025
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