Provider Demographics
NPI:1609806603
Name:ERNEST CHARLES DUNN,JR., MD, PA
Entity Type:Organization
Organization Name:ERNEST CHARLES DUNN,JR., MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:609-399-6263
Mailing Address - Street 1:1001 BRIGGS RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-4100
Mailing Address - Country:US
Mailing Address - Phone:856-231-4774
Mailing Address - Fax:856-231-9699
Practice Address - Street 1:1645 HAVEN AVE
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:NJ
Practice Address - Zip Code:08226-3066
Practice Address - Country:US
Practice Address - Phone:609-399-6263
Practice Address - Fax:609-399-5163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0053309Medicaid
NJ050822Medicare ID - Type Unspecified