Provider Demographics
NPI:1982679767
Name:BUNNELL, CRAIG ALAN (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:ALAN
Last Name:BUNNELL
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 1:44 BINNEY ST
Mailing Address - Street 2:DANA FARBER CANCER INSTITUTE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-632-3800
Mailing Address - Fax:617-632-1930
Practice Address - Street 1:44 BINNEY ST
Practice Address - Street 2:DANA FARBER CANCER INSTITUTE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-632-3800
Practice Address - Fax:617-632-1930
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75976207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G15481DFOtherHPHC DFCI ONLY
MA3174018Medicaid
722022OtherTUFTS
A20716OtherBC ELECT
3174018OtherMASSHEALTH
65519OtherFALLON COMM HEALTH PLAN
3040011OtherUNITED HEALTH CARE
4043401OtherCIGNA
MAA20716OtherMA BLUE CROSS BLUE SHIELD
A20716OtherINDEMNITY
110153281OtherRR MEDICARE DFCI
2172288OtherAETNA US HEALTHCARE
A20716OtherHMO BLUE
3040011OtherUNITED HEALTH CARE
A20716OtherINDEMNITY