Provider Demographics
NPI:1750678413
Name:BULL, JONCA CAMILLE (MD)
Entity Type:Individual
Prefix:DR
First Name:JONCA
Middle Name:CAMILLE
Last Name:BULL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1428 JUNIPER ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1416
Mailing Address - Country:US
Mailing Address - Phone:202-841-3190
Mailing Address - Fax:202-723-7777
Practice Address - Street 1:1428 JUNIPER ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1416
Practice Address - Country:US
Practice Address - Phone:202-841-3190
Practice Address - Fax:202-723-7777
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DC12600207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology