Provider Demographics
NPI:1043351349
Name:BUNKER, DONALD WAYNE (DC)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:WAYNE
Last Name:BUNKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13917 DOVER RD
Mailing Address - Street 2:
Mailing Address - City:APPLE CREEK
Mailing Address - State:OH
Mailing Address - Zip Code:44606
Mailing Address - Country:US
Mailing Address - Phone:330-857-8860
Mailing Address - Fax:330-683-9916
Practice Address - Street 1:13917 DOVER RD
Practice Address - Street 2:
Practice Address - City:APPLE CREEK
Practice Address - State:OH
Practice Address - Zip Code:44606
Practice Address - Country:US
Practice Address - Phone:330-857-8860
Practice Address - Fax:330-683-9916
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1311111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0731097Medicaid
T81980Medicare UPIN
OH0731097Medicaid