Provider Demographics
NPI:1962424028
Name:DUNFORD, CHRISTOPHER CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:CHARLES
Last Name:DUNFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:615 W MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3815
Mailing Address - Country:US
Mailing Address - Phone:301-762-6148
Mailing Address - Fax:301-309-1240
Practice Address - Street 1:12247 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5523
Practice Address - Country:US
Practice Address - Phone:301-434-8985
Practice Address - Fax:301-434-8067
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD31839207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD31839OtherLICENSE
MD008848Medicare ID - Type Unspecified
MDC61473Medicare UPIN