Provider Demographics
NPI:1770555245
Name:BUNGER, PATRICIA J (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:BUNGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 86370
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57118-6370
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:1001 E 21ST ST
Practice Address - Street 2:STE. 200
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1033
Practice Address - Country:US
Practice Address - Phone:605-322-5700
Practice Address - Fax:605-322-5704
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD21612080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0040494Medicaid
MN140M3BUOtherCC SYSTEMS/ BLUE PLUS
SD0040476OtherBLUE CROSS
SD25273OtherSANFORD HEALTH PLAN
SD412991028071OtherPREFERRED ONE
SD7101262Medicaid
IA1525162Medicaid
SDHP37125OtherHEALTHPARTNERS
NE46022474352Medicaid
SD57108C005OtherWPS TRICARE
ND12200Medicaid
SD16311OtherMIDLANDS CHOICE
SD2161OtherDAKOTACARE
SD766208OtherARAZ/ AMERICA'S PPO
MN127702OtherUCARE
SD2161OtherDAKOTACARE
MN127702OtherUCARE