Provider Demographics
NPI:1194773358
Name:DUNBAR, CHRISTINE R (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:R
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3346
Mailing Address - Country:US
Mailing Address - Phone:203-755-0163
Mailing Address - Fax:
Practice Address - Street 1:1211 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3106
Practice Address - Country:US
Practice Address - Phone:203-755-0163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000989363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT357229OtherWELLCARE
CT26-33542OtherAMERICHOICE
CT26-33542OtherUHC
CT2V9573OtherHEALTHNET/COMMERCIAL
CT7061719OtherAETNA
CT1064653OtherUSA
CT98900OtherCONNECTICARE
CTP00359922OtherRR MEDICARE
CT008009482Medicaid
CTP3412840OtherOXFORD
CT290000989CT03OtherANTHEM BCBS CT
CT1064653OtherUSA
CT26-33542OtherAMERICHOICE