Provider Demographics
NPI:1235119363
Name:BUNCH, ROGER L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:L
Last Name:BUNCH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USNH KEFLAVIK
Mailing Address - Street 2:PSC 1003 BOX 8
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09728
Mailing Address - Country:IS
Mailing Address - Phone:011354-425-3245
Mailing Address - Fax:
Practice Address - Street 1:USNH KEFLAVIK
Practice Address - Street 2:PSC 1003 BOX 8
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09728
Practice Address - Country:IS
Practice Address - Phone:011354-425-3245
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP 5512183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist