Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service | 1539 | NC |
NPI | 1104081140 |
---|---|
Provider Name | Mr. Joseph Henry Bunch |
First Address | Edenton, NC 27932-2048 |
Second Address | Edenton, NC 27932-2048 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2008 |
Last Update Date | 18/07/2008 |