Myrtle Beach Endocrinology

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

MD11983 Issued in SC

Legal business name

MYRTLE BEACH ENDOCRINOLOGY

Practice address

1039 44TH Avenue North
Suite 204
Myrtle Beach, SC 29577

Phone

(843) 839-3950

Fax

(843) 839-3955

NPI assigned

May 27, 2008

Last updated

Jul 16, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paul David Bunn, MD

Title

Physician Owner

Phone

(843) 267-1535

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1083872030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100523",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29501",
            "telephone_number": "843-669-5162",
            "fax_number": "843-771-4482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 44TH AVENUE NORTH",
            "address_2": "SUITE 204",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29577",
            "telephone_number": "843-839-3950",
            "fax_number": "843-839-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYRTLE BEACH ENDOCRINOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "BUNN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "843-267-1535",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "SC",
            "license": "MD11983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endocrinology, Diabetes & Metabolism Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Endocrinology, Diabetes & Metabolism Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.