Individual
AMANDA MARIE BUNNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
080162
GA
207L00000X
Anesthesiology Physician
Primary
83873
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2014
Last updated
11/24/2020
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