Basic Information
| Provider Information | |||||||||
| NPI: | 1821074899 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUNTEN | ||||||||
| FirstName: | BRADLEY | ||||||||
| MiddleName: | LE BLANG | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9903 CEDAR LN | ||||||||
| Address2: | |||||||||
| City: | BETHESDA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208144005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015305443 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8901 WISCONSIN AVE | ||||||||
| Address2: | |||||||||
| City: | BETHESDA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208890001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012954455 | ||||||||
| FaxNumber: | 3013198272 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2005 | ||||||||
| LastUpdateDate: | 07/24/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD-9827 | HI | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207P00000X | MD-9827 | HI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.