Provider Demographics
NPI:1790930097
Name:DUNBAR, STEPHANIE MILLER (CRNA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MILLER
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10845 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-1717
Mailing Address - Country:US
Mailing Address - Phone:410-335-0008
Mailing Address - Fax:410-335-3113
Practice Address - Street 1:1210 FOREST OAK CT
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6170
Practice Address - Country:US
Practice Address - Phone:410-688-7792
Practice Address - Fax:410-836-8064
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR159792207L00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD025855500OtherMEDICAL ASSISTANCE
DCBY10-0001OtherCAREFIRST
MD158523ZNS1OtherMEDICARE
MDBY10-0001OtherCAREFIRST
GAP01524968OtherRAILROAD MEDICARE