Healthcare Provider Details

I. General information

NPI: 1366538084
Provider Name (Legal Business Name): HOWARD G MUNTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 N 115TH ST SUITE 101
SEATTLE WA
98133-8414
US

IV. Provider business mailing address

1560 N 115TH ST SUITE 101
SEATTLE WA
98133-8414
US

V. Phone/Fax

Practice location:
  • Phone: 206-368-6806
  • Fax: 206-368-6808
Mailing address:
  • Phone: 206-368-6806
  • Fax: 206-368-6808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberMD00030427
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: