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Individual
DR. THEODORE J BUNT
Active
Individual
DR. THEODORE J BUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
9984
SC
2086S0129X
Vascular Surgery Physician
Primary
9984
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099841
—
SC
Enumeration date
04/26/2006
Last updated
10/24/2007
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