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Individual

DR. LAMONT TYLER BUNYON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3731 BRANCH AVE, SUITE #211, TEMPLE HILLS, MD 20748-1404
(301) 702-0090
(301) 702-0023
Mailing address
3731 BRANCH AVE, SUITE #211, TEMPLE HILLS, MD 20748-1404
(301) 702-0090
(301) 702-0023

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
TA1617
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
TA1617
STATE LICENSE
MD
Enumeration date
02/15/2007
Last updated
07/08/2007
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