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Individual

CHARLES MELVIN DUNGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
691 MURPHY RD STE 107, MEDFORD, OR 97504-4311
(541) 789-6460
(541) 789-6461
Mailing address
1510 HONEYSUCKLE AVE, MEDFORD, OR 97504-5560
(541) 789-6460
(541) 789-6461

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
200541311RN
OR
363LF0000X
Family Nurse Practitioner
Primary
202210480NP
OR

Other

Enumeration date
04/28/2022
Last updated
10/24/2022
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