Provider Demographics
NPI:1861506891
Name:MUNIR, MOHAMMAD M (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:M
Last Name:MUNIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 SW 160TH AVE
Mailing Address - Street 2:SUITE #250
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-6308
Mailing Address - Country:US
Mailing Address - Phone:305-866-9951
Mailing Address - Fax:
Practice Address - Street 1:15200 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20905-5631
Practice Address - Country:US
Practice Address - Phone:301-384-2166
Practice Address - Fax:571-349-0204
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0068037207R00000X, 207Q00000X
PAMD034193L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4175751 00Medicaid
PA0006883990001Medicaid
PA0006883990001Medicaid
DC135120ZBDDMedicare PIN
C30847Medicare UPIN
MD136860ZBLJMedicare PIN