Provider Demographics
NPI:1972084051
Name:DUNNEBACK, PAUL MATTHEW III (PA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:MATTHEW
Last Name:DUNNEBACK
Suffix:III
Gender:M
Credentials:PA
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Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:166 SPRINGBROOK AVE STE 101
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-8520
Practice Address - Country:US
Practice Address - Phone:919-550-3430
Practice Address - Fax:919-550-7403
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2021-05-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601008790363A00000X
NC0010-09244363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant