Basic Information
| Provider Information | |||||||||
| NPI: | 1770555245 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUNGER | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 86370 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571186370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227510 | ||||||||
| FaxNumber: | 6053226475 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 E 21ST ST | ||||||||
| Address2: | STE. 200 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053225700 | ||||||||
| FaxNumber: | 6053225704 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2006 | ||||||||
| LastUpdateDate: | 02/27/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080A0000X | 2161 | SD | Y | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0040494 | 05 | MT | MEDICAID | 140M3BU | 01 | MN | CC SYSTEMS/ BLUE PLUS | OTHER | 0040476 | 01 | SD | BLUE CROSS | OTHER | 25273 | 01 | SD | SANFORD HEALTH PLAN | OTHER | 412991028071 | 01 | SD | PREFERRED ONE | OTHER | 7101262 | 05 | SD | MEDICAID | 1525162 | 05 | IA | MEDICAID | HP37125 | 01 | SD | HEALTHPARTNERS | OTHER | 46022474352 | 05 | NE | MEDICAID | 57108C005 | 01 | SD | WPS TRICARE | OTHER | 12200 | 05 | ND | MEDICAID | 16311 | 01 | SD | MIDLANDS CHOICE | OTHER | 2161 | 01 | SD | DAKOTACARE | OTHER | 766208 | 01 | SD | ARAZ/ AMERICA'S PPO | OTHER | 127702 | 01 | MN | UCARE | OTHER |