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NPI Code Detail

MEDICARE: MABLE T DUNN PA-C

MEDICARE: MABLE T DUNN PA-C
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
1363AM0700XMedical Physician AssistantC0003944MD
2363AM0700XMedical Physician Assistant0110002849VA

General Provider Information

NPI Number : 1992943872
Entity Type Code : Individual
Provider Name (Legal Business Name) : MABLE T DUNN PA-C
Provider Business Mailing Address
First Line : 8908 RIGGS RD
Second Line :
City : ADELPHI
State : MD
Zip : 20783-1632
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8908 RIGGS RD
Second Line :
City : ADELPHI
State : MD
Zip : 20783-1632
Country : US
Telephone Number : 301-422-5900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2009
Last Update Date : 11/05/2012

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Directions to “ MABLE T DUNN PA-C” Practice Location

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