Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | J6933 | TX |
NPI | 1013195908 |
---|---|
Provider Name | Michael Patrick Dunnigan |
First Address | Greenville, TX 75402-3812 |
Second Address | Greenville, TX 75402-3812 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2008 |
Last Update Date | 04/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E78497 | (02) | TX |