Healthcare Provider Details

I. General information

NPI: 1497002760
Provider Name (Legal Business Name): CAREY ALAN BUNCH CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2012
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2664 SAINT MATTHEWS RD STE B
ORANGEBURG SC
29118-1344
US

IV. Provider business mailing address

2664 SAINT MATTHEWS RD STE B
ORANGEBURG SC
29118-1344
US

V. Phone/Fax

Practice location:
  • Phone: 803-534-6567
  • Fax: 803-937-6566
Mailing address:
  • Phone: 803-534-6567
  • Fax: 803-937-6566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: