Provider Demographics
NPI:1174374060
Name:CIFUENTES MUNOZ, JUAN SEBASTIAN (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:SEBASTIAN
Last Name:CIFUENTES MUNOZ
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 1:1500 E MEDICAL CENTER DRIVE
Mailing Address - Street 2:5346 CVC, SPC 5867
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-5867
Mailing Address - Country:US
Mailing Address - Phone:734-647-9867
Mailing Address - Fax:
Practice Address - Street 1:1500 E MEDICAL CENTER DRIVE, SPC 5856
Practice Address - Street 2:FCVC 3RD FLOOR, RECEPTION B
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5856
Practice Address - Country:US
Practice Address - Phone:734-936-5850
Practice Address - Fax:734-647-4285
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351054005390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program