Provider Demographics
NPI:1639348170
Name:BUNCH, SHERMAN DWAYNE SR
Entity Type:Individual
Prefix:MR
First Name:SHERMAN
Middle Name:DWAYNE
Last Name:BUNCH
Suffix:SR
Gender:M
Credentials:
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 56236
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70156-6236
Mailing Address - Country:US
Mailing Address - Phone:504-416-9793
Mailing Address - Fax:504-309-6688
Practice Address - Street 1:2428 RUE NOTRE DAME
Practice Address - Street 2:
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-8221
Practice Address - Country:US
Practice Address - Phone:504-416-9793
Practice Address - Fax:504-309-6688
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)