Provider Demographics
NPI:1700882214
Name:BUNAO, ALFRED SIDNEY B (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED SIDNEY
Middle Name:B
Last Name:BUNAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 CARTHAGE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4208
Mailing Address - Country:US
Mailing Address - Phone:919-777-0303
Mailing Address - Fax:919-776-0395
Practice Address - Street 1:409 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4208
Practice Address - Country:US
Practice Address - Phone:919-777-0303
Practice Address - Fax:919-776-0395
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89135G7Medicaid
H90664Medicare UPIN
NC2020691Medicare PIN
NCH90664Medicare UPIN