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General NPI Number Information
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NPI Number | 1982251567
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Entity Type | Individual
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Provider Name | MATTHEW DUNNING
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Gender | Male
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 1364 MAIN ST STE 6
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City | SANFORD
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State | ME
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Zip | 04073-3648
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Country | US
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Telephone | 207-881-5014
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Fax | 866-291-8520
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Provider Business Mailing Address
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Address Line | 11808 GRANT ST FL 100
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City | OMAHA
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State | NE
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Zip | 68164-3616
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Country | US
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Telephone | 877-230-3885
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PT5454
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT5454
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License Number State | ME
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