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Individual

JULIE SUZANNE BUNNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
58 16TH ST, WHEELING, WV 26003-3660
(304) 243-6410
(304) 243-6411
Mailing address
58 16TH ST, WHEELING, WV 26003-3660
(304) 243-6410
(304) 243-6411

Taxonomy

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

Other

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
Enumeration date
06/23/2005
Last updated
10/09/2012
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