Provider Demographics
NPI:1508864406
Name:BUNGER, CHARLENE N (WHNP)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:N
Last Name:BUNGER
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 SINGLETON RIDGE RD STE 385
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-9154
Mailing Address - Country:US
Mailing Address - Phone:843-349-0100
Mailing Address - Fax:843-349-0104
Practice Address - Street 1:620 SINGLETON RIDGE RD STE 385
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-9154
Practice Address - Country:US
Practice Address - Phone:843-349-0100
Practice Address - Fax:843-349-0104
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23863363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology