Provider Demographics
NPI:1114961133
Name:BUNCE, SCOTT S (PHD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:S
Last Name:BUNCE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 858 MCA410
Mailing Address - Street 2:THE MILTON S. HERSHEY MEDICAL CENTER
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2036
Mailing Address - Country:US
Mailing Address - Phone:717-531-5814
Mailing Address - Fax:717-531-0494
Practice Address - Street 1:22 NORTHEAST DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2732
Practice Address - Country:US
Practice Address - Phone:717-531-8338
Practice Address - Fax:717-531-6250
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008916L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001820057Medicaid
PA043349Medicare ID - Type Unspecified
PAP17271Medicare UPIN