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General NPI Number Information
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NPI Number | 1063497584
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Entity Type | Individual
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Provider Name | FREDRICK WILLIAM MUNZER DO
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Gender | Male
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 12/30/2022
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Provider Practice Location Address
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Address Line | 411 THEATRE DR
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City | JOHNSTOWN
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State | PA
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Zip | 15904-2838
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Country | US
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Telephone | 814-269-4507
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Fax | 814-288-0194
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Provider Business Mailing Address
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Address Line | 451 FULMER RD
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City | JOHNSTOWN
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State | PA
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Zip | 15904-4602
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Country | US
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Telephone | 814-269-4507
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Fax | 814-535-4819
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 05005422L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | OS005422L
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License Number State | PA
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