Individual
ANTJUAN MANDWELL BUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8147 BALTIMORE AVE STE C, COLLEGE PARK, MD 20740-2492
(240) 398-1909
Mailing address
3421 NEWTON ST, MOUNT RAINIER, MD 20712-2123
(240) 398-1909
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
221886
MD
Other
Enumeration date
02/03/2020
Last updated
02/19/2020
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