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General NPI Number Information
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NPI Number | 1013913011
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Entity Type | Individual
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Provider Name | JULIE SUZANNE BUNNER MD
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Gender | Female
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 58 16TH ST
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City | WHEELING
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State | WV
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Zip | 26003-3660
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Country | US
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Telephone | 304-243-6410
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Fax | 304-243-6411
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Provider Business Mailing Address
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Address Line | 58 16TH ST
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City | WHEELING
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State | WV
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Zip | 26003-3660
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Country | US
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Telephone | 304-243-6410
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Fax | 304-243-6411
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 19765
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License Number State | WV
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