Provider Demographics
NPI:1912955451
Name:BUNDA, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:BUNDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8001 FRANKLIN FARMS DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5108
Mailing Address - Country:US
Mailing Address - Phone:804-521-5800
Mailing Address - Fax:804-545-4340
Practice Address - Street 1:4700 PUDDLEDOCK RD
Practice Address - Street 2:400
Practice Address - City:PRINCE GEORGE
Practice Address - State:VA
Practice Address - Zip Code:23875-1268
Practice Address - Country:US
Practice Address - Phone:804-458-1740
Practice Address - Fax:804-541-1846
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101055720207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA276263OtherANTHEM/VA HEALTHKEEPERS
44212OtherSENTARA HEALTH/OPTIMA
5900505OtherAETNA/US HEALTHCARE
72343OtherSOUTHERN HEALTH SERV
VA5807387Medicaid
60045076OtherRAILROAD MEDICARE
VA276220OtherANTHEM/VA HEALTHKEEPERS
VA276287OtherANTHEM/VA HEALTHKEEPERS
VA103796OtherANTHEM/VA HEALTHKEEPERS
257162OtherMAMSI
VA276186OtherANTHEM/VA HEALTHKEEPERS
85717OtherCIGNA
VA271952OtherANTHEM/VA HEALTHKEEPERS
2001051OtherAETNA/US HEALTHCARE HMO
27413300OtherFEDERAL BLACK LUNG
VA276340OtherANTHEM/VA HEALTHKEEPERS
VA276340OtherANTHEM/VA HEALTHKEEPERS
060000805Medicare PIN