Healthcare Provider Details

I. General information

NPI: 1295741031
Provider Name (Legal Business Name): ROBERT BUNNING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 IRVING ST NW
WASHINGTON DC
20010-2921
US

IV. Provider business mailing address

102 IRVING ST NW
WASHINGTON DC
20010-2921
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-1000
  • Fax: 202-882-8434
Mailing address:
  • Phone: 202-877-1000
  • Fax: 202-882-8434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD14589
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: