Individual
MAYISHA WHITE-DUNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
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
207RA0401X
Addiction Medicine (Internal Medicine) Physician
2008-00186
NC
208100000X
Physical Medicine & Rehabilitation Physician
2008-00186
NC
208100000X
Physical Medicine & Rehabilitation Physician
Primary
90862
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5910806
—
NC
01
—
P00810246
MAYISHA DUNHAM PTAN
—
Enumeration date
07/13/2007
Last updated
01/28/2022
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