Healthcare Provider Details

I. General information

NPI: 1669436432
Provider Name (Legal Business Name): THOMAS EDWARD MUNSHOWER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROUTE 209 HARLEYSVILLE NATIONAL BANK BUILDING
KRESGEVILLE PA
18333
US

IV. Provider business mailing address

PO BOX 550 ROUTE 209 HARLEYSVILLE NATIONAL BANK
KRESGEVILLE PA
18333-0550
US

V. Phone/Fax

Practice location:
  • Phone: 610-681-6800
  • Fax: 610-681-6825
Mailing address:
  • Phone: 610-681-6800
  • Fax: 610-681-6825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS-007201-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: