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Individual

AUDREY LUDWIG BUNCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C, M.S.

Contact information

Practice address
28 BLACKWELL PARK LN, SUITE 302, WARRENTON, VA 20186-2685
(540) 341-1900
(540) 341-0940
Mailing address
28 BLACKWELL PARK LN, SUITE 302, WARRENTON, VA 20186-2685
(540) 341-1900
(540) 341-0940

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C0003830
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1245480318
VA
Enumeration date
09/25/2008
Last updated
04/12/2012
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