Healthcare Provider Details

I. General information

NPI: 1124765490
Provider Name (Legal Business Name): AJAH MONET DUNBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 05/17/2022
Certification Date: 05/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3489 SUMMIT CT NE
WASHINGTON DC
20018-1649
US

IV. Provider business mailing address

3489 SUMMIT CT NE
WASHINGTON DC
20018-1649
US

V. Phone/Fax

Practice location:
  • Phone: 240-343-4826
  • Fax:
Mailing address:
  • Phone: 240-343-4826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: