Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 4301060828 | MI |
NPI | 1013977503 |
---|---|
Provider Name | Dr. Robert B Dunne |
First Address | Northville, MI 48167-9773 |
Second Address | Detroit, MI 48236-2148 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 05/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104175201 | (05) | MI |
104175210 | (05) | MI |
G24724 | (02) | MI |
RD060828 | BC/BS OF MI (01) | MI |