Provider Demographics
NPI:1760438444
Name:DUNAGAN, DONNIE P (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNIE
Middle Name:P
Last Name:DUNAGAN
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 1:2042 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-4128
Mailing Address - Country:US
Mailing Address - Phone:706-733-1104
Mailing Address - Fax:706-736-8465
Practice Address - Street 1:2042 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-4128
Practice Address - Country:US
Practice Address - Phone:706-733-1104
Practice Address - Fax:706-736-8465
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2010-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA49886207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA282346OtherBCBS OF GA
GA000124936Medicaid
GAGRP4126Medicare ID - Type Unspecified
GAG70382Medicare UPIN