Individual
TIMOTHY P DUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
625 S NEW BALLAS RD, CREVE COEUR, MO 63141
(314) 251-1100
Mailing address
625 S NEW BALLAS RD, CREVE COEUR, MO 63141-8253
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
2017010080
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017010080
MISSOURI LICENSE NUMBER
MO
Enumeration date
03/23/2012
Last updated
07/09/2018
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