Individual
DUSTIN LEE DUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 MEDICAL PARK RD, COLUMBIA, SC 29203-6808
(803) 434-8800
(803) 434-8802
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4397PA
—
SC
Enumeration date
10/14/2020
Last updated
01/07/2021
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