Doctor Name: | DR. ELAINE MARIE BUNICK |
NPI Number: | 1750586343 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | MD11035 |
Business Practice Address: | 200 New York Ave Suite #160 Oak Ridge, TN - 378305212 |
Business Phone Number: | 8654835639 |
Business Fax Number: | 8654839346 |
Mailing Address: | 200 New York Ave, Suite #160 OAK RIDGE |
State: | TN |
Postal Code: | 378305212 |
Phone Number: | 8654835639 |
Fax Number: | 8654839346 |
NPI Enumeration Date: | 06/15/2007 |
NPI Last Update Date: | 01/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD11035 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |