Basic Information
Provider Information
NPI: 1932254331
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUNIO
FirstName: RICHARD
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 HOSPITAL RD
Address2: CALLER BOX C-268
City: CHEROKEE
State: NC
PostalCode: 287199253
CountryCode: US
TelephoneNumber: 8284979163
FaxNumber: 8284971723
Practice Location
Address1: 1 HOSPITAL RD
Address2: CALLER BOX C-268
City: CHEROKEE
State: NC
PostalCode: 287199253
CountryCode: US
TelephoneNumber: 8284979163
FaxNumber: 8284971723
Other Information
ProviderEnumerationDate: 01/24/2007
LastUpdateDate: 03/31/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X0099-01380NCY Allopathic & Osteopathic PhysiciansFamily Medicine 
208D00000X9001380NCN Allopathic & Osteopathic PhysiciansGeneral Practice 

ID Information
IDTypeStateIssuerDescription
193225433105NC MEDICAID
1308V01NCBCBSOTHER


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