MEDICARE: CHRISTOPHER D DUNTSCH MD

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	207T00000X	Neurological Surgery Physician	45161	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8DB527	OTHER	TX	BCBS
2	N8183	OTHER	TX	MEDICAL LICENSE

General Provider Information

NPI Number	:	1790916393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER D DUNTSCH MD

Provider Business Mailing Address
First Line	:	7712 SAN JACINTO PL
Second Line	:	STE 200
City	:	PLANO
State	:	TX
Zip	:	75024-3257
Country	:	US
Telephone Number	:	972-208-8475
Fax Number	:	972-208-8476

Provider Business Practice Location Address
First Line	:	7712 SAN JACINTO PL
Second Line	:	STE 200
City	:	PLANO
State	:	TX
Zip	:	75024-3257
Country	:	US
Telephone Number	:	972-208-8475
Fax Number	:	972-208-8476

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

Provider Enumeration Date	:	07/30/2009
Last Update Date	:	04/25/2012

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