1205944220 NPI number — DR. CHRISTOPHER E DUNN MD

Table of content: DR. CHRISTOPHER E DUNN MD (NPI 1205944220)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205944220 NPI number — DR. CHRISTOPHER E DUNN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUNN
Provider First Name:
CHRISTOPHER
Provider Middle Name:
E
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205944220
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/24/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2147
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT MYERS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33902-2147
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-468-0254
Provider Business Mailing Address Fax Number:
239-343-3958

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19511 HIGHLAND OAKS DR STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ESTERO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33928-9712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-468-0254
Provider Business Practice Location Address Fax Number:
239-343-3958
Provider Enumeration Date:
08/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  31919 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: ME162463 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 118953600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 080184656 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 621306 . This is a "UHC OF THE RIVER VALLEY" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 11042 . This is a "WELLMARK BCBS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1158493 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 118953600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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