Healthcare Provider Details

I. General information

NPI: 1407947922
Provider Name (Legal Business Name): PERCY ELFORD DUNAGIN JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUUHL REGIONAL MEDICAL CENTER CMR 402
APO AE
09180
US

IV. Provider business mailing address

CMR 402 BOX 51
APO AE
09180
US

V. Phone/Fax

Practice location:
  • Phone: 06371867318
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License Number19922
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: