Provider Demographics
NPI:1548257355
Name:MUN, ALVIN KAM (OD)
Entity type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:KAM
Last Name:MUN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1500 S WILLOW ST
Mailing Address - Street 2:LENSCRAFTERS
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3220
Mailing Address - Country:US
Mailing Address - Phone:603-626-6621
Mailing Address - Fax:603-645-9483
Practice Address - Street 1:1500 S WILLOW ST
Practice Address - Street 2:LENSCRAFTERS
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3220
Practice Address - Country:US
Practice Address - Phone:603-626-6621
Practice Address - Fax:603-645-9483
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH426152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH090228940NH01Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NUMBE
NHT25654Medicare UPIN
NHNH2289Medicare PIN