Provider Demographics
NPI:1104839729
Name:DUNN, LAURIE LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:LOUISE
Last Name:DUNN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 NEW BERN AVE
Mailing Address - Street 2:NEONATOLOGY
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1231
Mailing Address - Country:US
Mailing Address - Phone:919-350-8545
Mailing Address - Fax:919-350-8146
Practice Address - Street 1:3000 NEW BERN AVE
Practice Address - Street 2:NEONATOLOGY
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1231
Practice Address - Country:US
Practice Address - Phone:919-350-8545
Practice Address - Fax:919-350-8146
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0000-31492208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8929444Medicaid
NC8929444Medicaid