Provider Demographics
NPI:1013195908
Name:DUNNIGAN, MICHAEL PATRICK (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PATRICK
Last Name:DUNNIGAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8506 WESLEY ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-3812
Mailing Address - Country:US
Mailing Address - Phone:903-454-1824
Mailing Address - Fax:903-454-6044
Practice Address - Street 1:8506 WESLEY ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402-3812
Practice Address - Country:US
Practice Address - Phone:903-454-1824
Practice Address - Fax:903-454-6044
Is Sole Proprietor?:No
Enumeration Date:2008-02-04
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6933207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE78497Medicare UPIN
8B8336Medicare PIN
1382157OtherUNITED HEALTHCARE
TX8K8290OtherBLUE CROSS
8B8336Medicare PIN
4615361OtherAETNA