Healthcare Provider Details

I. General information

NPI: 1518997873
Provider Name (Legal Business Name): CHRISTIAN MUNK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 W HORIZON RIDGE PKWY STE 140
HENDERSON NV
89012-3502
US

IV. Provider business mailing address

511 TRENIER DR
HENDERSON NV
89002-9730
US

V. Phone/Fax

Practice location:
  • Phone: 702-878-0070
  • Fax: 702-818-1928
Mailing address:
  • Phone: 702-208-0866
  • Fax: 702-420-2534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number229045
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4572
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberDO1372
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: