MEDICARE: DR. ALVIN KAM MUN O.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
1	152W00000X	Optometrist	426	NH

General Provider Information

NPI Number	:	1548257355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALVIN KAM MUN O.D.

Provider Business Mailing Address
First Line	:	1500 S WILLOW ST
Second Line	:	LENSCRAFTERS
City	:	MANCHESTER
State	:	NH
Zip	:	03103-3220
Country	:	US
Telephone Number	:	603-626-6621
Fax Number	:	603-645-9483

Provider Business Practice Location Address
First Line	:	1500 S WILLOW ST
Second Line	:	LENSCRAFTERS
City	:	MANCHESTER
State	:	NH
Zip	:	03103-3220
Country	:	US
Telephone Number	:	603-626-6621
Fax Number	:	603-645-9483

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	07/18/2011

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