Provider Demographics
NPI:1306132154
Name:BUNCH, PAUL MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MICHAEL
Last Name:BUNCH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:GRAY 2 - ROOM 273A
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-726-8323
Mailing Address - Fax:617-724-3338
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:GRAY 2 - ROOM 273A
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-8323
Practice Address - Fax:617-724-3338
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2016-02-01
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Provider Licenses
StateLicense IDTaxonomies
VA01160236282085R0202X
MA2616192085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology