Provider Demographics
NPI:1023563160
Name:DUNN, PETER HOFFMAN (PTA)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:HOFFMAN
Last Name:DUNN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 MCGUCKIAN AVE UNIT 212
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4041
Mailing Address - Country:US
Mailing Address - Phone:410-271-7799
Mailing Address - Fax:
Practice Address - Street 1:1901 MCGUCKIAN AVE UNIT 212
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4041
Practice Address - Country:US
Practice Address - Phone:410-271-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA4480225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant