MEDICARE: GERALD PETER DUNN

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	183500000X	Pharmacist	13873	IA

General Provider Information

NPI Number	:	1750664793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALD PETER DUNN

Provider Business Mailing Address
First Line	:	2503 5TH AVE S
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-5552
Country	:	US
Telephone Number	:	515-576-7113
Fax Number	:

Provider Business Practice Location Address
First Line	:	2503 5TH AVE S
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-5552
Country	:	US
Telephone Number	:	515-576-7113
Fax Number	:

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

Provider Enumeration Date	:	09/26/2011
Last Update Date	:	09/26/2011

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Directions to “ GERALD PETER DUNN ” Practice Location

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