MEDICARE: DR. BRIAN R BUNT DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	0103000604	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730165218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN R BUNT DPM

Provider Business Mailing Address
First Line	:	400B HOSPITAL DR
Second Line	:
City	:	WARRENTON
State	:	VA
Zip	:	20186-3026
Country	:	US
Telephone Number	:	540-347-1370
Fax Number	:	540-349-4801

Provider Business Practice Location Address
First Line	:	400B HOSPITAL DR
Second Line	:
City	:	WARRENTON
State	:	VA
Zip	:	20186-3026
Country	:	US
Telephone Number	:	540-347-1370
Fax Number	:	540-349-4801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	12/22/2010

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