Basic Information
Provider Information | |||||||||
NPI: | 1346207172 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | BULL | ||||||||
FirstName: | JANET | ||||||||
MiddleName: | HUNTER | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 571 S ALLEN RD | ||||||||
Address2: |   | ||||||||
City: | FLAT ROCK | ||||||||
State: | NC | ||||||||
PostalCode: | 287319447 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8286926178 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 571 S ALLEN RD | ||||||||
Address2: |   | ||||||||
City: | FLAT ROCK | ||||||||
State: | NC | ||||||||
PostalCode: | 287319447 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8286926178 | ||||||||
FaxNumber: | 8282332594 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 04/26/2006 | ||||||||
LastUpdateDate: | 08/17/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 08/17/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 9800479 | NC | N |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   | 207VH0002X | 9800479 | NC | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Hospice and Palliative Medicine |
ID Information
ID | Type | State | Issuer | Description | 8912349 | 05 | NC |   | MEDICAID | 9800479 | 01 | NC | MEDICAL DOCTOR | OTHER | AB1691737 | 01 | NC | DEA | OTHER |