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General NPI Number Information
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NPI Number | 1962668848
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Entity Type | Individual
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Provider Name | ZERIHUN A. BUNAYE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/31/2008
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Last Update Date | 08/03/2017
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Provider Practice Location Address
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Address Line | 615 S NEW BALLAS RD
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8221
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Country | US
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Telephone | 314-251-6486
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Fax | 314-251-4155
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Provider Business Mailing Address
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Address Line | 625 S NEW BALLAS RD SUITE 7020
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8253
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Country | US
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Telephone | 314-251-6486
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Fax | 314-251-4155
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | E-9133
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2008011068
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License Number State | MO
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