# JULIE SUZANNE BUNNER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1013913011
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 19765 | WV | Yes |

## Other

- **Enumeration date:** 06/23/2005
- **Last updated:** 10/09/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 001718176 | MOUNTAIN STATE BCBS | — |
| 05 | — | 1812151000 | — | WV |
| 01 | — | 19765 | HEALTH PLAN OF UPPER OH V | — |
| 05 | — | 2325353 | — | OH |
| 01 | — | 55035705701 | WV COMPENSATION | WV |