Basic Information
Provider Information
NPI: 1174580708
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNN
FirstName: WILLIAM
MiddleName: B
NamePrefix:  
NameSuffix: III
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 491058
Address2:  
City: LAWRENCEVILLE
State: GA
PostalCode: 30049
CountryCode: US
TelephoneNumber: 7702374500
FaxNumber: 7702374539
Practice Location
Address1: 509 BILTMORE AVE
Address2: PATHOLOGY DEPT
City: ASHEVILLE
State: NC
PostalCode: 28801
CountryCode: US
TelephoneNumber: 8282530763
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/27/2006
LastUpdateDate: 10/11/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102X24382NCY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

ID Information
IDTypeStateIssuerDescription
892947905NC MEDICAID
P0027545501NCRAILROAD MEDICAREOTHER


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