Provider Demographics
NPI:1023099975
Name:BUNGER, DEBRA LYNNE (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:LYNNE
Last Name:BUNGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9055 SOQUEL DRIVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4039
Mailing Address - Country:US
Mailing Address - Phone:831-708-2919
Mailing Address - Fax:831-708-2937
Practice Address - Street 1:1201 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-9811
Practice Address - Country:US
Practice Address - Phone:270-417-7732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0495262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A495260Medicare ID - Type Unspecified