Provider Demographics
NPI:1477628105
Name:DUNN INTERNAL MEDICINE
Entity Type:Organization
Organization Name:DUNN INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MIDGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:910-892-0162
Mailing Address - Street 1:700 TILGHMAN DR
Mailing Address - Street 2:STE 724
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334
Mailing Address - Country:US
Mailing Address - Phone:910-892-0162
Mailing Address - Fax:910-892-1145
Practice Address - Street 1:700 TILGHMAN DR
Practice Address - Street 2:STE 724
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334
Practice Address - Country:US
Practice Address - Phone:910-892-0162
Practice Address - Fax:910-892-1145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:2007-03-21
Deactivation Code:
Reactivation Date:2007-09-11
Provider Licenses
StateLicense IDTaxonomies
NC23131207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
01452OtherBCBS
NC8901452Medicaid
0459Medicare ID - Type Unspecified
C85538Medicare UPIN