Provider Demographics
NPI:1467585729
Name:L JEAN DUNEGAN M.D. P.C.
Entity Type:Organization
Organization Name:L JEAN DUNEGAN M.D. P.C.
Other - Org Name:ST LUKE HOMETOWN HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DUNEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-623-8182
Mailing Address - Street 1:5065 MORET CT
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-4788
Mailing Address - Country:US
Mailing Address - Phone:810-623-8182
Mailing Address - Fax:810-225-0790
Practice Address - Street 1:9912 E GRAND RIVER AVE STE 1000
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1973
Practice Address - Country:US
Practice Address - Phone:810-623-8182
Practice Address - Fax:810-225-0790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301037571207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty