Provider Demographics
NPI:1275532590
Name:DUNKLE, CHAD H (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:H
Last Name:DUNKLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 PRESTIGE PL
Mailing Address - Street 2:SUITE 550
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-3794
Mailing Address - Country:US
Mailing Address - Phone:937-752-2305
Mailing Address - Fax:937-522-7513
Practice Address - Street 1:903 NW WASHINGTON BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-6386
Practice Address - Country:US
Practice Address - Phone:513-867-9000
Practice Address - Fax:513-785-3675
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2015-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35034840D207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0277294Medicaid
OH0277294Medicaid
OH0411416Medicare PIN
OHP00296010Medicare PIN
OHDU0411415Medicare PIN