Individual
MATTHEW ROBERT MUNGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-3318
Mailing address
500 MEDICAL CENTER BLVD STE 135, LAWRENCEVILLE, GA 30046-8708
(678) 312-3318
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
84890
GA
Other
Enumeration date
03/21/2017
Last updated
07/01/2020
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