Provider Demographics
NPI:1831158336
Name:DUNNE, GAY D (MD)
Entity type:Individual
Prefix:
First Name:GAY
Middle Name:D
Last Name:DUNNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 S PUGH ST
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-4734
Mailing Address - Country:US
Mailing Address - Phone:814-234-3381
Mailing Address - Fax:814-234-0994
Practice Address - Street 1:137 S PUGH ST
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4734
Practice Address - Country:US
Practice Address - Phone:814-234-3381
Practice Address - Fax:814-234-0994
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014693E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005870280001Medicaid
PAMD-014693EOtherMEDICAL LICENSE
PA079087Medicare ID - Type Unspecified
PA0005870280001Medicaid