Healthcare Provider Details

I. General information

NPI: 1427025675
Provider Name (Legal Business Name): MICHAEL E. DUNHAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 ESSEN LN STE 400
BATON ROUGE LA
70809-3738
US

IV. Provider business mailing address

7060 N RECREATION AVE SUITE 101
FRESNO CA
93720-8022
US

V. Phone/Fax

Practice location:
  • Phone: 225-765-1765
  • Fax: 225-765-1768
Mailing address:
  • Phone: 559-916-3406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberMD.207839
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberC52086
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: