Individual
MARK C BUGNITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
848 ADAMS AVE, MEMPHIS, TN 38103
(901) 287-7337
Mailing address
PO BOX 5135, MEMPHIS, TN 38101-5135
(901) 287-7337
(901) 287-6336
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
18163
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3028713
—
TN
Enumeration date
05/01/2006
Last updated
05/30/2018
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