MEDICARE: MRS. MARY JOSEPHINE DUNBAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	145052	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063401602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY JOSEPHINE DUNBAR M.D.

Provider Business Mailing Address
First Line	:	7270 BUCKLEY RD
Second Line	:
City	:	NORTH SYRACUSE
State	:	NY
Zip	:	13212-2649
Country	:	US
Telephone Number	:	315-458-6601
Fax Number	:	315-458-7940

Provider Business Practice Location Address
First Line	:	7270 BUCKLEY RD
Second Line	:
City	:	NORTH SYRACUSE
State	:	NY
Zip	:	13212-2649
Country	:	US
Telephone Number	:	315-458-6601
Fax Number	:	315-458-7940

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	04/07/2015

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