Provider Demographics
NPI:1194031211
Name:PETER K. DUNN, O.D., P.A.
Entity Type:Organization
Organization Name:PETER K. DUNN, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:H
Authorized Official - Last Name:CURRIE
Authorized Official - Suffix:
Authorized Official - Credentials:CPOA
Authorized Official - Phone:336-854-0066
Mailing Address - Street 1:306 MUIRS CHAPEL RD
Mailing Address - Street 2:STE B
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-6177
Mailing Address - Country:US
Mailing Address - Phone:336-854-0066
Mailing Address - Fax:336-252-1053
Practice Address - Street 1:306 MUIRS CHAPEL RD
Practice Address - Street 2:STE B
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-6177
Practice Address - Country:US
Practice Address - Phone:336-854-0066
Practice Address - Fax:336-252-1053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC1255152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7909244Medicaid
NC09244OtherBLUE CROSS BLUE SHIELD
NC3368540066OtherVISION SERVICE PLAN
NC09244OtherBLUE CROSS BLUE SHIELD
NCT81642Medicare UPIN