MEDICARE: MICHAEL PATRICK DUNNIGAN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	J6933	TX

General Provider Information

NPI Number	:	1013195908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL PATRICK DUNNIGAN DO

Provider Business Mailing Address
First Line	:	8506 WESLEY ST
Second Line	:
City	:	GREENVILLE
State	:	TX
Zip	:	75402-3812
Country	:	US
Telephone Number	:	903-454-1824
Fax Number	:	903-454-6044

Provider Business Practice Location Address
First Line	:	8506 WESLEY ST
Second Line	:
City	:	GREENVILLE
State	:	TX
Zip	:	75402-3812
Country	:	US
Telephone Number	:	903-454-1824
Fax Number	:	903-454-6044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2008
Last Update Date	:	08/04/2017

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