Healthcare Provider Details

I. General information

NPI: 1902301385
Provider Name (Legal Business Name): JOSHUA PETER MUNIZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 PRATT ST
DURHAM NC
27705-3976
US

IV. Provider business mailing address

2015 UPPERGATE DR ECC #400
ATLANTA GA
30322-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-8964
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number92018
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: