Provider Demographics
NPI:1598811556
Name:DUNLAP, PAUL LANGDON
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:LANGDON
Last Name:DUNLAP
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:USCG MLCA (KSE-2)
Mailing Address - Street 2:300 E. MAIN ST., SUITE 1000
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510
Mailing Address - Country:US
Mailing Address - Phone:757-628-4413
Mailing Address - Fax:
Practice Address - Street 1:USCG MLCA (KSE-2)
Practice Address - Street 2:300 E. MAIN ST., SUITE 1000
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510
Practice Address - Country:US
Practice Address - Phone:757-628-4413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA24720000XOtherCOAST GUARD HEALTH TECH