Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 22170 | SC |
Y | 207V00000X | Obstetrician & Gynecologist | 27431 | MT |
N | 207VX0000X | Obstetrician | 22170 | SC |
NPI | 1457348526 |
---|---|
Provider Name | Mrs. Margo Johanna Hein Muniz |
First Address | Havre, MT 59501-1231 |
Second Address | Havre, MT 59501-6207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2005 |
Last Update Date | 18/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
221708 | (05) | SC |
H39567 | (02) | SC |