Basic Information
| Provider Information | |||||||||
| NPI: | 1861506891 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MUNIR | ||||||||
| FirstName: | MOHAMMAD | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3601 SW 160TH AVE | ||||||||
| Address2: | SUITE #250 | ||||||||
| City: | MIRAMAR | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330276308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058669951 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 15200 NEW HAMPSHIRE AVE | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209055631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3013842166 | ||||||||
| FaxNumber: | 5713490204 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2006 | ||||||||
| LastUpdateDate: | 08/26/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D0068037 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD034193L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207Q00000X | D0068037 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 4175751 00 | 05 | MD | MEDICAID | 0006883990001 | 05 | PA | MEDICAID |