Healthcare Provider Details

I. General information

NPI: 1700856184
Provider Name (Legal Business Name): MICHAEL J DUNN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4248 HARBOR BEACH BLVD
BRIGANTINE NJ
08203-1361
US

IV. Provider business mailing address

1311 E SHORE DR
BRIGANTINE NJ
08203-3013
US

V. Phone/Fax

Practice location:
  • Phone: 609-266-0400
  • Fax:
Mailing address:
  • Phone: 609-266-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA44571
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberMA44571
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: