Provider Demographics
NPI:1639193659
Name:DUNHAM, CHRISTOPHER BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:BRIAN
Last Name:DUNHAM
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 1:6704 TAMERSON CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-2105
Mailing Address - Country:US
Mailing Address - Phone:415-265-9823
Mailing Address - Fax:
Practice Address - Street 1:3092 MARKET ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1825
Practice Address - Country:US
Practice Address - Phone:415-265-9823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG833392084P0800X
NC2013-014332084P0800X
PAMD042185L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD042185LOtherPENNSYLVANIA MEDICAL LICENSE
NC2013-01433OtherNORTH CAROLINA MEDICAL LICENSE 2013-01433
CAG83339OtherCALIFORNIA MEDICAL LICENSE NUMBER
PAMD042185LOtherPENNSYLVANIA MEDICAL LICENSE