Healthcare Provider Details

I. General information

NPI: 1689629438
Provider Name (Legal Business Name): ADELINA DUNN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 12/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 S QUEEN ANNE DR
FAIRLESS HILLS PA
19030-3811
US

IV. Provider business mailing address

605 S QUEEN ANNE DR
FAIRLESS HILLS PA
19030-3811
US

V. Phone/Fax

Practice location:
  • Phone: 215-949-2550
  • Fax: 215-949-1012
Mailing address:
  • Phone: 215-949-2550
  • Fax: 215-949-1012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-038087-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: