Provider Demographics
NPI:1891391058
Name:DUNSON, DAVID HENRY (RPH, CDE, MBA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:HENRY
Last Name:DUNSON
Suffix:
Gender:M
Credentials:RPH, CDE, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 397
Mailing Address - Street 2:
Mailing Address - City:NORTHFORK
Mailing Address - State:WV
Mailing Address - Zip Code:24868-0397
Mailing Address - Country:US
Mailing Address - Phone:304-862-2105
Mailing Address - Fax:304-862-2107
Practice Address - Street 1:112 TUMBLEWOOD RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24739-5600
Practice Address - Country:US
Practice Address - Phone:304-862-2105
Practice Address - Fax:304-862-2107
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20520130163WD0400X
WVRP0005267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator