Healthcare Provider Details

I. General information

NPI: 1003009853
Provider Name (Legal Business Name): GRACE DUNN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 N MAIN ST
BELL FL
32619-4713
US

IV. Provider business mailing address

23343 NW COUNTY ROAD 236
HIGH SPRINGS FL
32643-9669
US

V. Phone/Fax

Practice location:
  • Phone: 352-463-2374
  • Fax: 352-463-4507
Mailing address:
  • Phone: 352-463-2374
  • Fax: 352-463-2726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME104728
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: