Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1497002760 |
---|---|
Provider Name | Carey Alan Bunch |
First Address | Orangeburg, SC 29115-6022 |
Second Address | Orangeburg, SC 29115-6022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2012 |
Last Update Date | 26/07/2016 |