Provider Demographics
NPI:1013494319
Name:DUNBAR, ZACHARY (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:DUNBAR
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 OWINGS MILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-2857
Mailing Address - Country:US
Mailing Address - Phone:585-689-4488
Mailing Address - Fax:
Practice Address - Street 1:11001 OWINGS MILLS BLVD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-2857
Practice Address - Country:US
Practice Address - Phone:585-689-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL53522255A2300X
MDA00013582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer