Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD41057 | TN |
Y | 207QS0010X | Family Doctor - Sports Medicine | EC101036 | ME |
N | 207QS0010X | Family Doctor - Sports Medicine | MD41057 | TN |
NPI | 1043274046 |
---|---|
Provider Name | James Earl Dunlap |
First Address | Fairfield, ME 04937 |
Second Address | Fairfield, ME 04937 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 16/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F55175 | (02) | NV |