Provider Demographics
NPI:1245417708
Name:DUNIGAN, MICHAEL J (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:DUNIGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3166 NORTH OLD TRAIL
Mailing Address - Street 2:
Mailing Address - City:SHAMOKIN DAM
Mailing Address - State:PA
Mailing Address - Zip Code:17876-9409
Mailing Address - Country:US
Mailing Address - Phone:570-743-4333
Mailing Address - Fax:570-743-6012
Practice Address - Street 1:3166 NORTH OLD TRAIL
Practice Address - Street 2:
Practice Address - City:SHAMOKIN DAM
Practice Address - State:PA
Practice Address - Zip Code:17876-9409
Practice Address - Country:US
Practice Address - Phone:570-743-4333
Practice Address - Fax:570-743-6012
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006241L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA808250OtherBLUE SHIELD
PA0015697680004Medicaid
808250R2TMedicare PIN
PA0015697680004Medicaid