Individual
DEWAYNE M DUNHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
125 FRAZEE ST E, DETROIT LAKES, MN 56501-3501
(218) 844-2300
(218) 844-2444
Mailing address
PO BOX 727, DETROIT LAKES, MN 56502-0727
(218) 844-2300
(218) 844-2444
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R094125-3
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12324
—
MN
01
—
142332
UCARE #
MN
01
—
2000755
MEDICA #
MN
01
—
2T933DU
MNBS #
FM
01
—
3579
NDBS #
ND
01
—
3957
NDBS #
MN
01
—
40087
MNBS #
MN
01
—
56489DU
MNBS #
ND
01
—
DA9031015530
PREFERRED ONE #
MN
01
—
HP38638
HEALTHPARTNERS #
MN
01
—
ND200082
LHS/BANNERHEALTH #
ND
Enumeration date
06/08/2006
Last updated
07/09/2007
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