Provider Demographics
NPI:1255447116
Name:DUNN, CORWIN ROBERTS (MD)
Entity type:Individual
Prefix:
First Name:CORWIN
Middle Name:ROBERTS
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 1:7 GARDEN PLACE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208
Mailing Address - Country:US
Mailing Address - Phone:513-321-7414
Mailing Address - Fax:
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:SUITE 242
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-721-2024
Practice Address - Fax:513-721-7933
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH029554207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY356476167900Medicaid
OH0286677Medicaid
OH0144694Medicare PIN