Provider Demographics
NPI:1184784696
Name:MUNSON, CATHERINE LAURA (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:LAURA
Last Name:MUNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1590 CONSTITUTION BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3546
Mailing Address - Country:US
Mailing Address - Phone:803-548-2065
Mailing Address - Fax:803-328-3552
Practice Address - Street 1:1590 CONSTITUTION BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3546
Practice Address - Country:US
Practice Address - Phone:803-548-2065
Practice Address - Fax:803-328-3552
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC160942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCF38704Medicare UPIN