Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 18880 | SC |
NPI | 1033227079 |
---|---|
Provider Name | Charles Martin Bunke |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-8908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 20/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05073055 | (05) | MS |
1667854 | (05) | LA |
188807 | (05) | SC |
D32268 | (02) |