MEDICARE: DR. E CHARISSE DUNN DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	POOOO2182	FL

General Provider Information

NPI Number	:	1245347582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. E CHARISSE DUNN DPM

Provider Business Mailing Address
First Line	:	5610 PGA BLVD
Second Line	:	STE 212
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3838
Country	:	US
Telephone Number	:	561-776-7047
Fax Number	:	561-776-7049

Provider Business Practice Location Address
First Line	:	5610 PGA BLVD
Second Line	:	STE 212
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3838
Country	:	US
Telephone Number	:	561-776-7047
Fax Number	:	561-776-7049

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

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	07/09/2007

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