Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 30333 | AZ |
N | 207VG0400X | Gynecologist | 30333 | AZ |
NPI | 1114965605 |
---|---|
Provider Name | Dr. Michael Patrick Dunn |
First Address | Gilbert, AZ 85295-4880 |
Second Address | Gilbert, AZ 85295-6220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 25/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
696148 | (05) | AZ |
H35252 | (02) |