Healthcare Provider Details

I. General information

NPI: 1487383238
Provider Name (Legal Business Name): TODD MICHAEL DUNAWAY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 N CHURCH ST
GREENSBORO NC
27401-1007
US

IV. Provider business mailing address

1121 N CHURCH ST
GREENSBORO NC
27401-1007
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-4400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2025-01574
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11022165A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: