Basic Information
| Provider Information | |||||||||
| NPI: | 1487732848 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUNBAR-DAVIES | ||||||||
| FirstName: | WINNIFRED | ||||||||
| MiddleName: | JENNEH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 80982 | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234954349 | ||||||||
| FaxNumber: | 4234954934 | ||||||||
| Practice Location | |||||||||
| Address1: | 3300 WILCOX BLVD. | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4238039180 | ||||||||
| FaxNumber: | 4238039181 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2006 | ||||||||
| LastUpdateDate: | 02/01/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 27162 | TN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 5487562 | 01 | TN | CIGNA | OTHER | TN0101 | 01 | TN | UHCRIVERYVALLEY | OTHER | 4104835 | 01 | TN | BLUE CROSS BLUE SHIELD TN | OTHER | 100021923 | 01 | TN | PHP | OTHER |