Provider Demographics
NPI:1689629438
Name:DUNN, ADELINA (MD)
Entity Type:Individual
Prefix:DR
First Name:ADELINA
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 S QUEEN ANNE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-3811
Mailing Address - Country:US
Mailing Address - Phone:215-949-2550
Mailing Address - Fax:215-949-1012
Practice Address - Street 1:605 S QUEEN ANNE DR
Practice Address - Street 2:
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-3811
Practice Address - Country:US
Practice Address - Phone:215-949-2550
Practice Address - Fax:215-949-1012
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-038087-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA415521HQNMedicare ID - Type Unspecified
PA1832406HQNMedicare PIN
PAC33686Medicare UPIN