Provider Demographics
NPI:1770570533
Name:DUNNINGTON, ARTHUR RUSSELL (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:RUSSELL
Last Name:DUNNINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 FIRST COLONIAL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3172
Mailing Address - Country:US
Mailing Address - Phone:757-491-7359
Mailing Address - Fax:757-491-9359
Practice Address - Street 1:933 FIRST COLONIAL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3172
Practice Address - Country:US
Practice Address - Phone:757-491-7359
Practice Address - Fax:757-491-9359
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101025162174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006056415Medicaid
VA228988OtherUHC/MDIPA/OPC/MAMSI
VA024249OtherANTHEM HEALTHKEEPERS
NC8905409OtherNC MEDICAID
VA024249OtherANTHEM BCBS
VA006056415OtherVIRGINIA PREMIER
VA10175OtherOPTIMA/SENTARA
NC8905409OtherNC MEDICAID
VA110000888Medicare ID - Type Unspecified