Provider Demographics
NPI:1992748453
Name:DUNN, VAUGHN MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:VAUGHN
Middle Name:MICHAEL
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 1:30 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-2609
Mailing Address - Country:US
Mailing Address - Phone:203-661-3712
Mailing Address - Fax:
Practice Address - Street 1:148 EAST AVE
Practice Address - Street 2:SUITE 2-I
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5721
Practice Address - Country:US
Practice Address - Phone:203-866-8121
Practice Address - Fax:203-866-4193
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT017342207K00000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Not Answered207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB83457Medicare UPIN