Provider Demographics
NPI:1790805224
Name:DUNLOP, GENTRY R (MD)
Entity Type:Individual
Prefix:
First Name:GENTRY
Middle Name:R
Last Name:DUNLOP
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 1:4745 S HELENA WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1709
Mailing Address - Country:US
Mailing Address - Phone:303-400-2930
Mailing Address - Fax:
Practice Address - Street 1:4745 S HELENA WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1709
Practice Address - Country:US
Practice Address - Phone:303-400-2930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28729207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO28729OtherSTATE LICENSE