Provider Demographics
NPI:1689177826
Name:DUNNUM, ALEXANDER P (DO)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:P
Last Name:DUNNUM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9403 RIVER POINTE LN
Mailing Address - Street 2:
Mailing Address - City:RINGLE
Mailing Address - State:WI
Mailing Address - Zip Code:54471-9789
Mailing Address - Country:US
Mailing Address - Phone:715-581-0099
Mailing Address - Fax:
Practice Address - Street 1:620 JOHN PAUL JONES CIR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2111
Practice Address - Country:US
Practice Address - Phone:757-953-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-14
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102205752171000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes171000000XOther Service ProvidersMilitary Health Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0102205752OtherMEDICAL LICENSE