Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 01081092A | IN |
Y | 207VX0201X | Gynecologic Oncologist | MD025694E | PA |
NPI | 1336119114 |
---|---|
Provider Name | Dr. Charles J Dunton |
First Address | Wynnewood, PA 19096-3450 |
Second Address | Wynnewood, PA 19096-3450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 28/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01081092A | IN STATE LICENSE (01) | IN |
B36436 | (02) |