Provider Demographics
NPI:1124137286
Name:DUNLOP, JOHN T (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:T
Last Name:DUNLOP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:874 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519
Mailing Address - Country:US
Mailing Address - Phone:203-688-8200
Mailing Address - Fax:203-688-8204
Practice Address - Street 1:874 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519
Practice Address - Country:US
Practice Address - Phone:203-688-8200
Practice Address - Fax:203-688-8204
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT52936207R00000X
IL036051507207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT5476347OtherCIGNA
CT1124137286Medicaid
CT446815OtherHEALTHY CT
CT1124137286OtherANTHEM
CT1124137286OtherMULTIPLAN
CTP01396400OtherRR MEDICARE
CT1289323OtherCOVENTRY
CT1124137286OtherCONNECTICARE
CTAA417900OtherHARVARD PILGRIM
CT1124137286OtherUNITED HEALTHCARE
CT1077074OtherWELLCARE
CT1124137286OtherTRICARE
CTP5110395OtherOXFORD
CT4403455OtherAETNA
CTAA417900OtherHARVARD PILGRIM