Provider Demographics
NPI:1497798409
Name:DUNN, ERNEST C JR (MD)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:C
Last Name:DUNN
Suffix:JR
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:PO BOX 729
Mailing Address - Street 2:606 MAIN ST
Mailing Address - City:BAYBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28515-0729
Mailing Address - Country:US
Mailing Address - Phone:252-745-3191
Mailing Address - Fax:252-745-7385
Practice Address - Street 1:606 MAIN ST
Practice Address - Street 2:
Practice Address - City:BAYBORO
Practice Address - State:NC
Practice Address - Zip Code:28515-9632
Practice Address - Country:US
Practice Address - Phone:252-745-3191
Practice Address - Fax:252-745-7385
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24967207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8929440Medicaid
NC206038BMedicare ID - Type Unspecified
NC8929440Medicaid