Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 0103301051 | VA |
N | 213ES0103X | Foot & Ankle Surgery | PO1000107 | DC |
NPI | 1003078213 |
---|---|
Provider Name | Monique R. Muronda |
First Address | White Marsh, MD 21162-1717 |
Second Address | Leesburg, VA 20176-1244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2008 |
Last Update Date | 28/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
081745500 | MEDICAL ASSISTANCE (01) | DC |
1003078214 | MEDICAL ASSISTANCE (01) | VA |