Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 82846 | GA |
NPI | 1376961565 |
---|---|
Provider Name | Dr. Anna Wilson Bunker |
First Address | Athens, GA 30606-6316 |
Second Address | Athens, GA 30606-6316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2014 |
Last Update Date | 20/09/2019 |