Individual
PETER ANDREW BUNDGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 HOSPITAL DR, WALTHALL COUNTY GENERAL HOSPITAL, TYLERTOWN, MS 39667-2022
(601) 876-2122
Mailing address
PO BOX 940, WASHINGTON, MS 39190-0940
(601) 446-6899
(601) 304-9714
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
15002
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0117315
—
MS
Enumeration date
07/19/2006
Last updated
07/08/2007
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