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NPI Code Detail

MEDICARE: DORIAN BUNN

MEDICARE: DORIAN BUNN
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
1103K00000XBehavior Analyst1-24-70673NM

General Provider Information

NPI Number : 1962951434
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORIAN BUNN
Provider Business Mailing Address
First Line : 2805 S INDUSTRIAL HWY STE 100
Second Line :
City : ANN ARBOR
State : MI
Zip : 48104-6791
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4801 MONTANO RD NW STE A2
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87120-2423
Country : US
Telephone Number : 505-366-0560
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2016
Last Update Date : 07/22/2025

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Directions to “ DORIAN BUNN ” Practice Location

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