Healthcare Provider Details

I. General information

NPI: 1215240809
Provider Name (Legal Business Name): MATTHEW ALAN DUNN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2010
Last Update Date: 07/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 MEDICAL PLAZA DR
CHARLESTON SC
29406-9104
US

IV. Provider business mailing address

1241 WOODLAND AVE
MT PLEASANT SC
29464-3288
US

V. Phone/Fax

Practice location:
  • Phone: 843-824-0606
  • Fax: 843-824-0909
Mailing address:
  • Phone: 843-824-0606
  • Fax: 843-824-0909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMT190755
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: