MEDICARE: MUBASHAR MUNIR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	065666	GA

General Provider Information

NPI Number	:	1518971944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUBASHAR MUNIR M.D.

Provider Business Mailing Address
First Line	:	226 EAST COLLEGE ST
Second Line	:	SUITE B
City	:	GRIFFIN
State	:	GA
Zip	:	30224-4249
Country	:	US
Telephone Number	:	678-987-1490
Fax Number	:	678-987-1491

Provider Business Practice Location Address
First Line	:	226 EAST COLLEGE ST
Second Line	:	SUITE B
City	:	GRIFFIN
State	:	GA
Zip	:	30224-4249
Country	:	US
Telephone Number	:	678-987-1490
Fax Number	:	678-987-1491

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	09/25/2014

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