Individual
DONAL P DUNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2622 LAKE AVE, FORT WAYNE, IN 46805-5410
(260) 425-3100
(260) 425-3604
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01048039A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200171850A
—
IN
01
—
471400234
MEDICARE PROVIDER PTAN
IN
Enumeration date
03/10/2006
Last updated
03/03/2021
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