MEDICARE: ESSENTIAL HEALTH, PC

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	207V00000X	Obstetrics & Gynecology Physician	24039	AL

General Provider Information

NPI Number	:	1508823055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSENTIAL HEALTH, PC

Provider Business Mailing Address
First Line	:	PO BOX 1505
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35807-0505
Country	:	US
Telephone Number	:	256-882-5595
Fax Number	:	256-883-1268

Provider Business Practice Location Address
First Line	:	475 PROVIDENCE MAIN ST NW
Second Line	:	SUITE 201
City	:	HUNTSVILLE
State	:	AL
Zip	:	35806-4815
Country	:	US
Telephone Number	:	256-882-5595
Fax Number	:	256-883-1268

Authorized Official
Title or Position	:	PRESIDENT/ PHYSICIAN
Name	:	DR. WHITNEY DUNHAM
Credential	:	MD
Telephone Number	:	256-882-5595

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	12/15/2011

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