Provider Demographics
NPI:1104811934
Name:DUNBAR, MARK R (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:R
Last Name:DUNBAR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2500 HOSPITAL BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4907
Mailing Address - Country:US
Mailing Address - Phone:770-475-0123
Mailing Address - Fax:770-442-9526
Practice Address - Street 1:2500 HOSPITAL BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4907
Practice Address - Country:US
Practice Address - Phone:770-475-0123
Practice Address - Fax:770-442-9526
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
GA022750207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD29348Medicare UPIN