Provider Demographics
NPI:1235491341
Name:DUNN, MESHA LUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MESHA
Middle Name:LUAN
Last Name:DUNN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:MESHA
Other - Middle Name:LUAN
Other - Last Name:GOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1402 REDTAIL ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-5192
Mailing Address - Country:US
Mailing Address - Phone:970-324-7014
Mailing Address - Fax:
Practice Address - Street 1:1522 E A ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2217
Practice Address - Country:US
Practice Address - Phone:307-234-6161
Practice Address - Fax:307-234-7033
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY9085A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine