Healthcare Provider Details

I. General information

NPI: 1336751106
Provider Name (Legal Business Name): DEBORAH DUNBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2020
Last Update Date: 11/27/2023
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 S MAIN ST
DARLINGTON SC
29532-5649
US

IV. Provider business mailing address

620 MOOREFIELD PARK DR
NORTH CHESTERFIELD VA
23236-3692
US

V. Phone/Fax

Practice location:
  • Phone: 803-608-8067
  • Fax:
Mailing address:
  • Phone: 180-464-4225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: