Individual
MRS. CYNTHIA ANN BUNDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
429 WASHINGTON AVE, POCATELLO, ID 83201-4520
(208) 233-6245
(208) 233-1065
Mailing address
429 WASHINGTON AVE, POCATELLO, ID 83201-4520
(208) 233-6245
(208) 233-1065
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-306
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010155655
REGENCE-BS OF IDAHO
ID
05
—
805811300
—
ID
01
—
P00382898
RAILROAD MEDICARE
—
01
—
PAG74
BLUE CROSS OF IDAHO
ID
Enumeration date
05/16/2006
Last updated
08/28/2015
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