Provider Demographics
NPI:1366975328
Name:DUNBAR, ELIZABETH G (PA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:G
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:G
Other - Last Name:LIBBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-0001
Mailing Address - Country:US
Mailing Address - Phone:603-650-8456
Mailing Address - Fax:
Practice Address - Street 1:228 E HARVEY FARM RD
Practice Address - Street 2:
Practice Address - City:WATERBURY CENTER
Practice Address - State:VT
Practice Address - Zip Code:05677-7117
Practice Address - Country:US
Practice Address - Phone:802-498-4133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT055.0031370363A00000X
NH1593363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant