Provider Demographics
NPI:1043274046
Name:DUNLAP, JAMES EARL (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EARL
Last Name:DUNLAP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SHERIDAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04937
Mailing Address - Country:US
Mailing Address - Phone:207-453-3000
Mailing Address - Fax:207-453-3301
Practice Address - Street 1:4 SHERIDAN DRIVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:ME
Practice Address - Zip Code:04937
Practice Address - Country:US
Practice Address - Phone:207-453-3000
Practice Address - Fax:207-453-3301
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEEC101036207QS0010X
TNMD41057207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVF55175Medicare UPIN
ME001825601Medicare PIN