Healthcare Provider Details

I. General information

NPI: 1851400873
Provider Name (Legal Business Name): JANET A. MUNROE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANET A. MUNROE M. D.

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

1499 WALTON WAY SUITE 1400
AUGUSTA GA
30901
AX

V. Phone/Fax

Practice location:
  • Phone: 706-721-9729
  • Fax: 706-721-8507
Mailing address:
  • Phone: 706-828-6416
  • Fax: 706-722-7235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number044210
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: