Provider Demographics
NPI:1609836055
Name:DUNHAM, DENARDO DOLPHIN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DENARDO
Middle Name:DOLPHIN
Last Name:DUNHAM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7311 DOWNMAN RD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-1213
Mailing Address - Country:US
Mailing Address - Phone:504-241-5707
Mailing Address - Fax:504-241-1945
Practice Address - Street 1:7311 DOWNMAN RD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-1213
Practice Address - Country:US
Practice Address - Phone:504-241-5707
Practice Address - Fax:504-241-1945
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD088R213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1397245Medicaid
LA4229310001Medicare NSC
T91229Medicare UPIN
LA56523C346Medicare PIN