Provider Demographics
NPI:1740200880
Name:DUNNINGTON, GANSEVOORT H (MD)
Entity Type:Individual
Prefix:DR
First Name:GANSEVOORT
Middle Name:H
Last Name:DUNNINGTON
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 1:8001 FRANKLIN FARMS DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5108
Mailing Address - Country:US
Mailing Address - Phone:804-521-5800
Mailing Address - Fax:804-545-4340
Practice Address - Street 1:5875 BREMO RD
Practice Address - Street 2:SUITE 505
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1934
Practice Address - Country:US
Practice Address - Phone:804-282-2685
Practice Address - Fax:804-282-0780
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101023860207RI0011X
VA010123860207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI103855OtherANTHEM/VA HEALTHKEEPERS
VA276348OtherANTHEM/VA HEALTHKEEPERS
VA44218OtherSENTARA HEALTH/OPTIMA
VA56222OtherSOUTHERN HEALTH SERVICES
VAP00226693OtherRAILROAD MEDICARE
VA1416688OtherCIGNA
VA4138009OtherAETNA US HEALTHCARE
VA6093558Medicaid
VA27413300OtherFEDERAL BLACK LUNG
VA311982OtherMAMSI
VA272173OtherAETNA US HEALTHCARE HMO
VA28746OtherANTHEM/VA HEALTHKEEPERS
VAP00226693OtherRAILROAD MEDICARE
VA6093558Medicaid