Healthcare Provider Details

I. General information

NPI: 1437227972
Provider Name (Legal Business Name): MICHAEL J. DUNN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 12/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39450 W 12 MILE RD 3RD FLOOR
NOVI MI
48377-3600
US

IV. Provider business mailing address

39450 12 MILE ROAD HENRY FORD HEALTH SYSTEM
NOVI MI
48377
US

V. Phone/Fax

Practice location:
  • Phone: 248-344-2490
  • Fax: 248-344-2492
Mailing address:
  • Phone: 248-344-2490
  • Fax: 248-344-2492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number049873
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number049873
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: