Provider Demographics
NPI:1275959959
Name:DUNBAR, HERBERT
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:
Last Name:DUNBAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3096 MONTAUK HILL DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-8623
Mailing Address - Country:US
Mailing Address - Phone:678-520-5423
Mailing Address - Fax:
Practice Address - Street 1:3096 MONTAUK HILL DR
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-8623
Practice Address - Country:US
Practice Address - Phone:678-520-5423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA06588227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified