Provider Demographics
NPI:1306963434
Name:MUNOZ-POSADA, EMMANUEL (MD)
Entity type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:
Last Name:MUNOZ-POSADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:EMMANUEL
Other - Middle Name:
Other - Last Name:MUNOZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:918 CHESTNUT RIDGE RD
Mailing Address - Street 2:STE 9
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2822
Mailing Address - Country:US
Mailing Address - Phone:304-598-2632
Mailing Address - Fax:304-599-1952
Practice Address - Street 1:918 CHESTNUT RIDGE RD
Practice Address - Street 2:STE 9
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2822
Practice Address - Country:US
Practice Address - Phone:304-598-2632
Practice Address - Fax:304-599-1952
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12617208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV12617OtherSTATE LICENSE
AM1964659OtherFEDERAL DEA
D83529Medicare UPIN