Provider Demographics
NPI:1972698439
Name:MUNN, ALBERT ROGERS III (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:ROGERS
Last Name:MUNN
Suffix:III
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:CAPITAL EYE CENTER
Mailing Address - Street 2:720 W JONES ST
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1427
Mailing Address - Country:US
Mailing Address - Phone:919-834-7341
Mailing Address - Fax:919-833-6008
Practice Address - Street 1:CAPITAL EYE CENTER
Practice Address - Street 2:720 W JONES ST
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1427
Practice Address - Country:US
Practice Address - Phone:919-834-7341
Practice Address - Fax:919-833-6008
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC30564207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7961377Medicaid
NCE06712Medicare UPIN
NC2140371DMedicare ID - Type Unspecified
NC7961377Medicaid