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General NPI Number Information
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NPI Number | 1679574818
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Entity Type | Organization
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Legal Business Name | BENJAMIN E DUNLAP MD PA
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 925 THOMAS ST FAMILY PRACTICS
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City | STATESVILLE
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State | NC
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Zip | 28677-3484
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Country | US
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Telephone | 704-872-7636
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Fax | 704-872-7750
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Provider Business Mailing Address
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Address Line | 925 THOMAS ST FAMILY PRACTICS
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City | STATESVILLE
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State | NC
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Zip | 28677-3484
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Country | US
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Telephone | 704-872-7636
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Fax | 704-872-7750
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Authorized Official
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Title or Position | MD
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Name | BENJAMIN E DUNLAP
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Credential | MD
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Telephone | 704-872-7636
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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 | 13789
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License Number State | NC
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