Provider Demographics
NPI:1972796381
Name:DUNN, MICHAEL J (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:DUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10040 REGENCY CIR STE 375
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3755
Mailing Address - Country:US
Mailing Address - Phone:402-934-0044
Mailing Address - Fax:402-934-0048
Practice Address - Street 1:17030 LAKESIDE HILLS PLZ
Practice Address - Street 2:#102
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2396
Practice Address - Country:US
Practice Address - Phone:402-758-5800
Practice Address - Fax:402-758-5809
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2019-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE11167207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE04416OtherBCBS - IMP
NE6402OtherMIDLANDS CHOICE
NE0402912OtherUHC SHARE ADVANTAGE - IMP
NE0402910OtherUHC SHARE ADVANTAGE
NE04421OtherBLUE CROSS BLUE SHIELD
NE6402OtherMIDLANDS CHOICE
NE281696Medicare PIN
NE281695Medicare PIN