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General NPI Number Information
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NPI Number | 1417007808
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Entity Type | Individual
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Provider Name | GENA COLLEEN DUNIVAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 1700 6TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-1802
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Country | US
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Telephone | 205-996-3130
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55310
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City | BIRMINGHAM
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State | AL
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Zip | 35255-5310
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | MD2010-0175
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 2007-00553
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | MD2010-0175
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 43934
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License Number State | AL
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