Provider Demographics
NPI:1700832425
Name:DUNN, LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:
Last Name:DUNN
Suffix:
Gender:M
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:2006-05-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-015978E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAAD8419764OtherDEA
PAAD8419764OtherDEA
PAC32963Medicare UPIN