Individual
DR. GERALD FRANK BUNTING-BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5380 E KACHINA ST, DAVIS MONTHAN A F B, AZ 85707-4923
(520) 228-4926
Mailing address
2125 E GOLF AVE, TEMPE, AZ 85282-4031
(480) 201-0781
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
13051
NE
207Q00000X
Family Medicine Physician
31378
AZ
2084P0800X
Psychiatry Physician
13051
NE
2084P0800X
Psychiatry Physician
Primary
31378
AZ
Other
Enumeration date
12/29/2005
Last updated
11/15/2007
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