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NPI Code Detail

MEDICARE: BRUNILDA MUNIR LATE M.D.

MEDICARE: BRUNILDA MUNIR LATE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician0101271547VA
2207P00000XEmergency Medicine PhysicianMD464746PA
32083A0300XAddiction Medicine (Preventive Medicine) PhysicianD0090980MD
4390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1477949295
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUNILDA MUNIR LATE M.D.
Provider Business Mailing Address
First Line : 13400 EDGEMEADE RD
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20772-8088
Country : US
Telephone Number : 717-763-2901
Fax Number : 717-763-2803
Provider Business Practice Location Address
First Line : 13400 EDGEMEADE RD
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20772-8088
Country : US
Telephone Number : 301-358-0192
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2015
Last Update Date : 06/20/2023

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