Healthcare Provider Details

I. General information

NPI: 1033392659
Provider Name (Legal Business Name): GREGORY NEIL DUNN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 08/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 MDG UNIT 5210 BOX 230
APO AE
09461-0230
US

IV. Provider business mailing address

PSC 41 BOX 6394
APO AE
09464-9998
US

V. Phone/Fax

Practice location:
  • Phone: 011163852090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2008-00782
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: