Provider Demographics
NPI:1982685863
Name:BUNCH, MORGAN R III (MD)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:R
Last Name:BUNCH
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:95 BULLDOG BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3332
Mailing Address - Country:US
Mailing Address - Phone:321-727-2990
Mailing Address - Fax:321-724-0455
Practice Address - Street 1:2181 S PATRICK DR
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4475
Practice Address - Country:US
Practice Address - Phone:321-777-1316
Practice Address - Fax:321-309-5002
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2012-03-06
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Provider Licenses
StateLicense IDTaxonomies
FLME46088207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05559OtherBLUE CROSS BLUE SHIELD
FL080082876OtherRAILROAD MEDICARE
FL4064464OtherAETNA
FL8278605006OtherCIGNA
FL046975100Medicaid
FL0804929OtherAETNA
FL05559AMedicare PIN
D84882Medicare UPIN