Provider Demographics
NPI:1518940105
Name:DUNN, CHARLES A (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:A
Last Name:DUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4950 SW 42ND AVE
Mailing Address - Street 2:STE A
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2231
Mailing Address - Country:US
Mailing Address - Phone:305-661-6566
Mailing Address - Fax:305-661-7166
Practice Address - Street 1:4950 SW 42ND AVE
Practice Address - Street 2:STE A
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2231
Practice Address - Country:US
Practice Address - Phone:305-661-6566
Practice Address - Fax:305-661-7166
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2007-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL10655207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD59357Medicare UPIN
FL90769Medicare PIN