Individual
JONATHAN TODD MUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.C.
Contact information
Practice address
1234 HUFFMAN MILL RD, BURLINGTON, NC 27215-8700
(336) 538-1234
(336) 538-2390
Mailing address
PO BOX 1717, BURLINGTON, NC 27216-1717
(336) 538-1234
(336) 538-2390
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
103035
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8101201
—
NC
Enumeration date
08/02/2006
Last updated
09/26/2022
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