Provider Demographics
NPI:1407809544
Name:DUNKER, DANIEL HENRY (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:HENRY
Last Name:DUNKER
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 1:5615 SPINNAKER PT
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152-6109
Mailing Address - Country:US
Mailing Address - Phone:816-520-3443
Mailing Address - Fax:
Practice Address - Street 1:5615 SPINNAKER PT
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MO
Practice Address - Zip Code:64152-6109
Practice Address - Country:US
Practice Address - Phone:816-520-3443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002007279207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203814306Medicaid
MOP00853579OtherMEDICARE RAILROAD
F60268Medicare UPIN
431092652 A004OtherCHAMPUS TRICARE
4482016OtherAETNA
4482016OtherAETNA HMO
MOMA2231009Medicare PIN
MO454B876AMedicare ID - Type Unspecified
33202011OtherBLUE SHIELD OF KC PPO
4482016OtherAETNA PPO
33202011OtherBLUE SHIELD OF KC HMO
P00076754OtherMEDICARE RAILROAD
MO1407809544Medicaid
MOMA3395005Medicare PIN