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NPI Code Detail

MEDICARE: RACHEL E. DUNHAM MD

MEDICARE: RACHEL E. DUNHAM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician01076446AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417397977
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL E. DUNHAM MD
Provider Business Mailing Address
First Line : 710 N NILES AVE
Second Line :
City : SOUTH BEND
State : IN
Zip : 46617-1924
Country : US
Telephone Number : 574-647-1610
Fax Number : 574-237-6069
Provider Business Practice Location Address
First Line : 206 W WARREN ST
Second Line :
City : MIDDLEBURY
State : IN
Zip : 46540-9410
Country : US
Telephone Number : 574-825-2146
Fax Number : 574-825-2182
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2013
Last Update Date : 07/26/2016

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