ANTJUAN MANDWELL BUNN (NPI# 1790316206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790316206 |
| Entity Type | Individual |
| Full Name | ANTJUAN MANDWELL BUNN |
| Practice Address |
8147 Baltimore Ave Ste C College Park MD 20740-2492 |
| Mailing Address |
3421 Newton St Mount Rainier MD 20712-2123 |
| Practice Telephone | 2403981909 |
| Mailing Telephone | 2403981909 |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-02-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1744P3200X |
Specialist Specialization: Prosthetics Case Management |
221886 | MD | Other Service Providers |
| Street Address |
8147 BALTIMORE AVE STE C |
| City | COLLEGE PARK |
| State | MD |
| Zip Code | 20740-2492 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073147633 | S.a.f.e. Counseling Services LLC | Counselor | 6210 Greenbelt Road, L 4, Berwyn Heights, MD 20740 | 2020-02-23 |
| 1326528621 | Ryan Rehabilitation LLC | Counselor | 7100 Baltimore Ave Ste 105, College Park, MD 20740 | 2018-08-16 |
| 1760981120 | L. Jones-dove & Associates Tooth Spa LLC | Dentist | 6103 Greenbelt Road, College Park, MD 20740 | 2018-02-12 |
| 1538682257 | Heather Gambacorto | Behavior Technician | 3525 Marlbrough Way, College Park, MD 20740 | 2017-07-25 |
| 1841722691 | Bradley Weitzel | Specialist/Technologist | 4068 Field House Drive, College Park, MD 20740 | 2017-03-31 |
| 1083152284 | Kabrima Y Petty | Nurse Practitioner | 10201 Baltimore Ave Apt 5102, College Park, MD 20740 | 2017-02-08 |
| 1659728517 | Brownstone Project In Md | Community/Behavioral Health | 6201 Greenbelt Rd Ste M6, Berwyn Heights, MD 20740 | 2016-05-20 |
| 1114371093 | Thomas Lowell Bennett | Specialist/Technologist | 7675 Baltimore Ave, R 0100, College Park, MD 20740 | 2016-04-18 |
| 1306226808 | Linda Ronma Williams | Nurse Practitioner | 4701 Melbourne Place, College Park, MD 20740 | 2015-06-01 |
| 1124427927 | Sarah Elizabeth Woerner | Pharmacist | 7300 Baltimore Boulevard, College Park, MD 20740 | 2014-08-18 |
| Find all providers in zip 20740 | ||||
| Taxonomy Code | 1744P3200X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| Specialization | Prosthetics Case Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881188787 | Shandrika Dannae Washington | Specialist | 5400 Riverstation Blvd Ste 104, College Park, GA 30349-5303 | 2018-06-14 |
| 1205338449 | Lawanna Tremetrice Gray | Specialist | 3741 College St, College Park, GA 30337-3541 | 2018-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153633 | Katreia Chareece White | Specialist | 5612 Saint Barnabas Rd, Oxon Hill, MD 20745-3626 | 2020-10-27 |
| 1437766482 | Natalyn Obey | Specialist | 10095 Washington Blvd N Ste 134, Laurel, MD 20723-1968 | 2020-09-24 |
| 1013528686 | Melissa Hammond | Specialist | 595 Main St Ste 235a, Laurel, MD 20707-4352 | 2020-08-16 |
| 1497373492 | Irene Marie Watkins | Specialist | 595 Main St Ste 235, Laurel, MD 20707-4352 | 2020-07-07 |
| 1073138285 | Andria Jackson | Specialist | 9560 Marlboro Pike Ste 105, Upper Marlboro, MD 20772-3770 | 2020-06-12 |
| 1467074849 | Martha Tanesha Hines | Specialist | 3407 Fort Meade Rd Ste 14, Laurel, MD 20724-2003 | 2020-05-08 |
| 1215558473 | Teraga Gross | Specialist | 5201 Ivanhoe Ave, Baltimore, MD 21212-4322 | 2020-04-29 |
| 1275168312 | Barry Staten | Specialist | 2323 Shadyside Ave, Suitland, MD 20746-4827 | 2020-03-09 |
| 1609401066 | Demarcus Tyler | Specialist | 5526 Belair Rd, Baltimore, MD 21206-3614 | 2020-03-05 |
| 1912538976 | Latreshia Shanae Maximo- Bowman | Specialist | 5441 Baltimore National Pike Ste 2a, Baltimore, MD 21229-2102 | 2020-01-29 |
| Find all providers with the same taxonomy | ||||
| City | COLLEGE PARK |
| Zip Code | 20740 |
Please comment or provide details below to improve the information on ANTJUAN MANDWELL BUNN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.