Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 16674 | AL |
Y | 208600000X | Surgeon | 16674 | AL |
NPI | 1013928316 |
---|---|
Provider Name | Dr. Lawrence H. Bundrick |
First Address | Huntsville, AL 35801-3455 |
Second Address | Huntsville, AL 35801-3455 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 08/07/2007 |