Healthcare Provider Details

I. General information

NPI: 1033366927
Provider Name (Legal Business Name): KRISTEN BUNCH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2008
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-5001
US

IV. Provider business mailing address

620 POPLARWOOD PL
GAITHERSBURG MD
20877-1257
US

V. Phone/Fax

Practice location:
  • Phone: 88-290-2798
  • Fax:
Mailing address:
  • Phone: 808-829-0279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberDOS-1851
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: