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NPI Code Detail

MEDICARE: CLYDE AUGUSTUS DUNN III

MEDICARE: CLYDE AUGUSTUS DUNN III
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
1208000000XPediatrics Physician87592SC
2208M00000XHospitalist Physician87592SC

General Provider Information

NPI Number : 1508506726
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLYDE AUGUSTUS DUNN III
Provider Business Mailing Address
First Line : PO BOX 751874
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1874
Country : US
Telephone Number : 843-402-5200
Fax Number :
Provider Business Practice Location Address
First Line : 2095 HENRY TECKLENBURG DR
Second Line :
City : CHARLESTON
State : SC
Zip : 29414-5733
Country : US
Telephone Number : 843-402-1634
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2022
Last Update Date : 02/23/2026

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