Provider Demographics
NPI:1982830055
Name:DUNBAR, PAUL THOMAS (IDMT)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:THOMAS
Last Name:DUNBAR
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MDOS/SGOMI
Mailing Address - Street 2:UNIT 5269 BOX 10
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96368-5269
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18 MDOS/SGOMI
Practice Address - Street 2:KADENA AIRBASE JAPAN
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96368-5269
Practice Address - Country:US
Practice Address - Phone:315-630-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians