MEDICARE: MICHAEL L. MUND, M.D., F.A.C.S., P.A.

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	207W00000X	Ophthalmology Physician	25MA02610200	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912925868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL L. MUND, M.D., F.A.C.S., P.A.

Provider Business Mailing Address
First Line	:	1187 MAIN AVE
Second Line	:	STE. 1F
City	:	CLIFTON
State	:	NJ
Zip	:	07011-2252
Country	:	US
Telephone Number	:	973-546-6161
Fax Number	:	973-546-1708

Provider Business Practice Location Address
First Line	:	1187 MAIN AVE
Second Line	:	STE. 1F
City	:	CLIFTON
State	:	NJ
Zip	:	07011-2252
Country	:	US
Telephone Number	:	973-546-6161
Fax Number	:	973-546-1708

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL L MUND
Credential	:	M.D.
Telephone Number	:	973-546-6161

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	08/22/2020

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