Provider Demographics
NPI:1013009547
Name:DUNKELBERG, RAY H (MD)
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:H
Last Name:DUNKELBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 GALLIMORE RD
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-8874
Mailing Address - Country:US
Mailing Address - Phone:828-884-4846
Mailing Address - Fax:828-877-5054
Practice Address - Street 1:377 GALLIMORE RD
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-8874
Practice Address - Country:US
Practice Address - Phone:828-884-4846
Practice Address - Fax:828-877-5054
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20258207R00000X
SC5357207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC04-70392OtherUNITED HEALTHCARE
NC0637660001OtherPALMETTO GOVERNMENT SERVI
NC8929416Medicaid
NC29416OtherBLUE CROSS BLUE SHIELD
NC080084316OtherRAILROAD MEDICARE
NC561852981DOtherCIGNA
NCC80805Medicare UPIN
NC080084316OtherRAILROAD MEDICARE