Individual
NANCY J BUNGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 582-1234
(573) 582-1212
Mailing address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 582-1234
(573) 582-1212
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36268
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164407946
—
MO
Enumeration date
12/14/2005
Last updated
05/31/2016
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