Provider Demographics
NPI:1790928570
Name:DUNN, EVAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:J
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 1:287 MAIN ST STE 404
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7056
Mailing Address - Country:US
Mailing Address - Phone:207-795-2171
Mailing Address - Fax:207-795-8330
Practice Address - Street 1:287 MAIN ST STE 404
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7056
Practice Address - Country:US
Practice Address - Phone:207-795-2171
Practice Address - Fax:207-795-8330
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD21651208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology