Provider Demographics
NPI:1659380731
Name:DUNBAR, JAMES DAVID (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:DUNBAR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:J.
Other - Middle Name:DAVID
Other - Last Name:DUNBAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 2193
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-2193
Mailing Address - Country:US
Mailing Address - Phone:803-609-3889
Mailing Address - Fax:
Practice Address - Street 1:9308 TWO NOTCH RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6401
Practice Address - Country:US
Practice Address - Phone:803-609-3889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC408101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCWP9990Medicaid