MEDICARE: DR. ERIC MUNOZ 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	6217A	WY
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	01089616A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	780001530	OTHER	WY	RAILROAD MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	308054	OTHER	WY	BLUE SHIELD

General Provider Information

NPI Number	:	1982607529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC MUNOZ M.D.

Provider Business Mailing Address
First Line	:	144 S 21ST ST
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-5732
Country	:	US
Telephone Number	:	307-262-1408
Fax Number	:

Provider Business Practice Location Address
First Line	:	144 S 21ST ST
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-5732
Country	:	US
Telephone Number	:	307-262-1408
Fax Number	:

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	02/14/2024

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Directions to “ DR. ERIC MUNOZ M.D.” Practice Location

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