Provider Demographics
NPI:1922155688
Name:DUNN, MICHAEL LYNN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LYNN
Last Name:DUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:850 E HARVARD AVE STE 265
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5075
Mailing Address - Country:US
Mailing Address - Phone:303-986-2274
Mailing Address - Fax:303-986-2205
Practice Address - Street 1:850 E HARVARD AVE STE 265
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5075
Practice Address - Country:US
Practice Address - Phone:303-986-2274
Practice Address - Fax:303-986-2205
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28808207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01288083Medicaid
D35605Medicare UPIN