Provider Demographics
NPI:1619394152
Name:BUNCHER, NOAH ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:NOAH
Middle Name:ADAM
Last Name:BUNCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 RIVERWOODS DR
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-2246
Mailing Address - Country:US
Mailing Address - Phone:267-261-0454
Mailing Address - Fax:
Practice Address - Street 1:1700 S BROAD ST APT 301
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-2340
Practice Address - Country:US
Practice Address - Phone:215-467-5870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-22
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS023189208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics