Provider Demographics
NPI:1700834397
Name:DUNNINGTON, DAVID C (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
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 1:430 W VOTAW ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47371-1302
Mailing Address - Country:US
Mailing Address - Phone:260-726-6515
Mailing Address - Fax:260-726-6535
Practice Address - Street 1:430 W VOTAW ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:IN
Practice Address - Zip Code:47371-1302
Practice Address - Country:US
Practice Address - Phone:260-726-6515
Practice Address - Fax:260-726-6535
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058449A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INF67469Medicare UPIN
IN142560OMedicare ID - Type UnspecifiedMEDICARE