Provider Demographics
NPI:1760446363
Name:DUNKELBERGER, GEORGE ROGER (DO)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ROGER
Last Name:DUNKELBERGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6776 54TH AVE N
Mailing Address - Street 2:SUITE B
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-1405
Mailing Address - Country:US
Mailing Address - Phone:727-548-8500
Mailing Address - Fax:727-317-3758
Practice Address - Street 1:6776 54TH AVE N
Practice Address - Street 2:SUITE B
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-1405
Practice Address - Country:US
Practice Address - Phone:727-548-8500
Practice Address - Fax:727-317-3758
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS8970207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01450402OtherRAILROAD MEDICARE
FL014675900Medicaid
FL37965OtherBCBS
FL7260316OtherCIGNA
FL7260316OtherCIGNA