{
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"IsOrgSubpart": "N",
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"OrgName": "CANAN AVUNDUK, MD. PHD",
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"FirstLineMailingAddress": "1715 BROADWAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAUGUS",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "01906-4703",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "781-979-6370",
"MailingAddressFaxNumber": "781-979-6373",
"FirstLinePracticeLocationAddress": "536 LEBANON ST",
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"PracticeLocationAddressCityName": "MELROSE",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "02176-3523",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "781-979-0286",
"PracticeLocationAddressFaxNumber": "781-979-0324",
"EnumerationDate": "06/24/2008",
"LastUpdateDate": "06/24/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DUNN",
"AuthorizedOfficialFirstName": "CATHLEEN",
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"AuthorizedOfficialTitle": "PHYSICIAN ACCOUNT REPRESENTATIVE",
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"AuthorizedOfficialTelephoneNumber": "781-979-6366",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RG0100X",
"TaxonomyName": "Gastroenterology Physician",
"LicenseNumber": "46084",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}