Healthcare Provider Details

I. General information

NPI: 1093725301
Provider Name (Legal Business Name): JEFFREY PAUL MUENCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 06/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11119 ROCKVILLE PIKE STE 409
ROCKVILLE MD
20852
US

IV. Provider business mailing address

11119 ROCKVILLE PIKE STE 409
ROCKVILLE MD
20852-3143
US

V. Phone/Fax

Practice location:
  • Phone: 301-230-9299
  • Fax: 301-230-9220
Mailing address:
  • Phone: 301-230-9299
  • Fax: 301-654-8384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberD0057591
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberD0057591
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: