Individual
CLINTON MATTHEW BUNDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 944-5000
(317) 963-5492
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
02006711A
IN
208000000X
Pediatrics Physician
5151013983
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962063198
ANTHEM PTAN
IN
05
—
300062059
—
IN
Enumeration date
06/27/2019
Last updated
03/04/2025
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