Individual
RANDALL EARL BUNDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LP
Contact information
Practice address
1407 S STATE ST, NEW ULM, MN 56073
(507) 354-3181
(507) 354-3183
Mailing address
1407 S STATE ST, NEW ULM, MN 56073-3715
(507) 354-3181
(507) 354-3183
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
LP1021
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122361
UCARE
MN
01
—
150226
UCARE
MN
05
—
230222500
—
MN
01
—
45396BU
BCBS
MN
01
—
8441161
UBH/MEDICA
MN
01
—
84722
HEALTH PARTNERS
MN
Enumeration date
07/25/2006
Last updated
06/30/2018
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