Basic Information
| Provider Information | |||||||||
| NPI: | 1053653469 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNBAR | ||||||||
| FirstName: | EDWARD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4530 PENNY LN | ||||||||
| Address2: | |||||||||
| City: | DODGEVILLE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 535338971 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6083333193 | ||||||||
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| Practice Location | |||||||||
| Address1: | 600 HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537921473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082636400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2013 | ||||||||
| LastUpdateDate: | 01/25/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 65664 | WI | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.