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General NPI Number Information
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NPI Number | 1104880137
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Entity Type | Individual
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Provider Name | VICTOR EDWARD DUNHAM MD
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Gender | Male
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 845 8TH ST NE SUITE 3
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City | MASSILLON
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State | OH
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Zip | 44646-8511
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Country | US
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Telephone | 330-830-3258
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Fax | 330-830-6928
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Provider Business Mailing Address
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Address Line | 60 MT. PLEASANT ROAD
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City | CLINTON
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State | OH
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Zip | 44216
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Country | US
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Telephone | 330-882-4934
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.053779
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License Number State | OH
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