Provider Demographics
NPI:1124078092
Name:DUNN, DANIEL HUGH (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:HUGH
Last Name:DUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WESTWOOD DR S
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55416-3361
Mailing Address - Country:US
Mailing Address - Phone:763-377-3658
Mailing Address - Fax:
Practice Address - Street 1:2545 CHICAGO AVE
Practice Address - Street 2:SUITE 601
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4522
Practice Address - Country:US
Practice Address - Phone:612-863-7770
Practice Address - Fax:612-863-7772
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN21578174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN37T88DUOtherBLUE CROSS BLUE SHIELD
MN527875900Medicaid
MN30843300OtherWISCONSIN MA
MN122058D417OtherUCARE
MN1700085OtherMEDICA
MNHP13201OtherHEALTHPARTNERS
MN1700085OtherMEDICA
MN527875900Medicaid