Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 0101035687 | VA |
N | 207RA0401X | Internist - Addiction Medicine | 0101035687 | VA |
NPI | 1073545232 |
---|---|
Provider Name | David W Munter |
First Address | Cincinnati, OH 45202-1457 |
Second Address | Chesapeake, VA 23320-3866 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6056750 | (05) | VA |
D91474 | (02) | VA |