Provider Demographics
NPI:1518946458
Name:BUNDY, ROBERT FRANCIS JR (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FRANCIS
Last Name:BUNDY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:106 CORPORATE PARK DR.
Practice Address - Street 2:SUITE 200 & 300
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-7134
Practice Address - Country:US
Practice Address - Phone:704-235-9090
Practice Address - Fax:704-235-9101
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9401384207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8919757Medicaid
NCF97821Medicare UPIN
NC8919757Medicaid