Individual
DWIGHT EARL BUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO MPH
Contact information
Practice address
400 N JEFFERSON ST, LEWISBURG, WV 24901
(304) 645-3220
(304) 645-4103
Mailing address
400 N JEFFERSON ST, LEWISBURG, WV 24901
(304) 645-3220
(304) 645-4103
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
965
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051233000
—
WV
Enumeration date
02/01/2006
Last updated
11/23/2009
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