Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 2021-01515 | NC |
NPI | 1053750059 |
---|---|
Provider Name | Dr. Colin Bruce Muncie |
First Address | Raleigh, NC 27604-0010 |
Second Address | Raleigh, NC 27610-1855 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2013 |
Last Update Date | 24/11/2021 |