Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 050358 | GA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 050358 | GA |
NPI | 1144218157 |
---|---|
Provider Name | Dr. Michael J Dunn |
First Address | Brunswick, GA 31520-4851 |
Second Address | Brunswick, GA 31520-4851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 23/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00914152A | (05) | GA |
H42511 | (02) | GA |