Basic Information
Provider Information
NPI: 1528066545
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MUNSON
FirstName: AMIE
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 9007
Address2:  
City: CHARLOTTESVILLE
State: VA
PostalCode: 229069007
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1850 ROSSER AVE
Address2:  
City: WAYNESBORO
State: VA
PostalCode: 229803237
CountryCode: US
TelephoneNumber: 5409421200
FaxNumber: 4349420151
Other Information
ProviderEnumerationDate: 07/13/2005
LastUpdateDate: 09/23/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X0101057021VAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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