Provider Demographics
NPI:1871736728
Name:MUNOZ, MAURA E (MD)
Entity type:Individual
Prefix:MS
First Name:MAURA
Middle Name:E
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:11 WILBRAHAM RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-3161
Practice Address - Country:US
Practice Address - Phone:413-794-3710
Practice Address - Fax:413-794-9595
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA256189208000000X, 207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine