Healthcare Provider Details

I. General information

NPI: 1972122083
Provider Name (Legal Business Name): AFFAN MUNIR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date: 01/10/2022
Reactivation Date: 08/04/2022

III. Provider practice location address

11890 HEALING WAY
SILVER SPRING MD
20904-7917
US

IV. Provider business mailing address

10 BERGEN CT APT 2C
BAYONNE NJ
07002-2125
US

V. Phone/Fax

Practice location:
  • Phone: 240-637-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0096410
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: