Provider Demographics
NPI:1699038489
Name:DUNN, MICHAEL L (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:DUNN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 1/2 S 50TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-3505
Mailing Address - Country:US
Mailing Address - Phone:480-888-6724
Mailing Address - Fax:
Practice Address - Street 1:109 1/2 S 50TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3505
Practice Address - Country:US
Practice Address - Phone:480-888-6724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13840183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist