MEDICARE: DR. DAVID J. WUNDER DC

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	111N00000X	Chiropractor	38MC00477300	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	U78537	OTHER	NJ	MEDICARE DR. ID# BOX 17A

Other Identifiers

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

General Provider Information

NPI Number	:	1750453692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID J. WUNDER DC

Provider Business Mailing Address
First Line	:	410 CHESTNUT ST
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-9306
Country	:	US
Telephone Number	:	908-624-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 CHESTNUT ST
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-9306
Country	:	US
Telephone Number	:	908-624-9000
Fax Number	:

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. DAVID J. WUNDER DC” Practice Location

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