Provider Demographics
NPI:1548576747
Name:BUNTON, TIMOTHY JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JAMES
Last Name:BUNTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1807 HUGUENOT RD STE 117
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-5604
Mailing Address - Country:US
Mailing Address - Phone:617-655-3979
Mailing Address - Fax:
Practice Address - Street 1:1807 HUGUENOT RD STE 117
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-5604
Practice Address - Country:US
Practice Address - Phone:804-506-0526
Practice Address - Fax:804-506-0526
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2023-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2536602084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry