Provider Demographics
NPI:1275531428
Name:DUNN, THADDEUS LELAND (MD)
Entity Type:Individual
Prefix:DR
First Name:THADDEUS
Middle Name:LELAND
Last Name:DUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7353
Mailing Address - Country:US
Mailing Address - Phone:910-343-3345
Mailing Address - Fax:910-343-1924
Practice Address - Street 1:1090 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7353
Practice Address - Country:US
Practice Address - Phone:910-343-3345
Practice Address - Fax:910-343-1924
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31493207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Not Answered207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4828881OtherUNITED HEALTHCARE PROVIDE
NC88073OtherMEDOCST PROVIDER NUMBER
NC8929445Medicaid
NC29445OtherBCBS OF NC PROVIDER NUMBE
NC8929445Medicaid
NC206046EMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER