Individual provider · NPI-1

Matthew Andrew Bubnis, DO, DPT

Family Medicine · Camp Lejeune, NC

NPI number1063482669
StatusActive
Last updated in NPPESDec 11, 2025

Details

NPI
1063482669
Entity type
Individual (NPI-1)
Name
Mr. Matthew Andrew Bubnis
Credential
DO, DPT
Sex
Male
Sole proprietor
No
Enumeration date
Jan 25, 2006
Certification date
Dec 11, 2025
Last updated
Dec 11, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine0116027999VAYes
207QS0010X Family Medicine, Sports Medicine0102204665VA

Practice location

Fc309 Hm Smith Blvd
Camp Lejeune, NC 28547

Phone 910-451-5125

Mailing address

Fc309 Hm Smith Blvd
Camp Lejeune, NC 28547

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