Provider Demographics
NPI:1518729979
Name:DUNNE, AIDAN (PA-C)
Entity Type:Individual
Prefix:
First Name:AIDAN
Middle Name:
Last Name:DUNNE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2191 S MCCLELLAND ST APT 634
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-4562
Mailing Address - Country:US
Mailing Address - Phone:314-624-9712
Mailing Address - Fax:
Practice Address - Street 1:2191 S MCCLELLAND ST APT 634
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-4562
Practice Address - Country:US
Practice Address - Phone:314-624-9712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant