Individual
DR. MARK S MUNROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 330-3688
(812) 331-3656
Mailing address
PO BOX 1329, BLOOMINGTON, IN 47402-1329
(812) 353-3087
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01036737A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000110400
ANTHEM
IN
05
—
100167000
—
IN
Enumeration date
10/06/2006
Last updated
01/14/2021
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