Organization
DUNHAM ENTERPRISES, PA
Active
Other names
Dunham Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAYISHA W DUNHAM M.D. (OFFICER/OWNER)
(252) 258-0480
Entity
Organization
Contact information
Practice address
170 WHITMORE COVE CT, CLEMMONS, NC 27012-8883
(252) 258-0480
Mailing address
170 WHITMORE COVE CT, CLEMMONS, NC 27012-8883
(252) 258-0480
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2005-01758
NC
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2008-00186
NC
2084P0800X
Psychiatry Physician
2005-01758
NC
208M00000X
Hospitalist Physician
2005-01758
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
151347
NC MEDICAL BOARD REG NO.
NC
01
—
1588863161
MAYISHA DUNHAM NPI
—
01
—
DQ0513
GROUP PTAN
—
01
—
P00810246
MAYISHA DUNHAM PTAN
—
Enumeration date
09/25/2008
Last updated
07/13/2020
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