Provider Demographics
NPI:1427087543
Name:DUNN, JOHN M (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:DUNN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:22 OLD MAIN STREET
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05464-0157
Mailing Address - Country:US
Mailing Address - Phone:802-644-1432
Mailing Address - Fax:802-644-1454
Practice Address - Street 1:22 OLD MAIN STREET
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:VT
Practice Address - Zip Code:05464-0157
Practice Address - Country:US
Practice Address - Phone:802-644-1432
Practice Address - Fax:802-644-1454
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2019-09-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VT042.0008623207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0003394Medicaid
VTE75628Medicare UPIN
VT0003394Medicaid
VTY400331773Medicare PIN