MEDICARE: DR. ANDREA HELEN MUNRO 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
1	207P00000X	Emergency Medicine Physician	A141138	CA
2	207P00000X	Emergency Medicine Physician	1018630	MA

General Provider Information

NPI Number	:	1710248463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA HELEN MUNRO M.D.

Provider Business Mailing Address
First Line	:	680 CENTRE ST
Second Line	:
City	:	BROCKTON
State	:	MA
Zip	:	02302-3308
Country	:	US
Telephone Number	:	508-941-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2703 BELLEVUE AVE
Second Line	:	APT 1
City	:	LOS ANGELES
State	:	CA
Zip	:	90026
Country	:	US
Telephone Number	:	248-765-8072
Fax Number	:

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

Provider Enumeration Date	:	05/30/2012
Last Update Date	:	05/06/2026

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