Individual
CHARLES EDWARD BUNNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1055 SAXON BLVD, DEPT. OF PATHOLOGY, ORANGE CITY, FL 32763-8468
(386) 651-5000
(386) 917-5159
Mailing address
PO BOX 144333, ORLANDO, FL 32814-4333
(407) 422-9831
(407) 648-2065
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME20258
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00232851
RAILROAD MEDICARE
—
Enumeration date
11/22/2005
Last updated
08/10/2007
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