Provider Demographics
NPI:1598948580
Name:DAVID A. DUNN MD PC
Entity Type:Organization
Organization Name:DAVID A. DUNN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-375-6546
Mailing Address - Street 1:300 CHAPMAN ST RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13664
Mailing Address - Country:US
Mailing Address - Phone:315-375-6546
Mailing Address - Fax:
Practice Address - Street 1:300 CHAPMAN ST RD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NY
Practice Address - Zip Code:13664
Practice Address - Country:US
Practice Address - Phone:315-375-6546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161865208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01654104Medicaid
NYB81957Medicare UPIN
NY01654104Medicaid