Basic Information
| Provider Information | |||||||||
| NPI: | 1447247697 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNHAM | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | I | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 SW ARCHER RD | ||||||||
| Address2: | BOX 100254 | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326100254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522738610 | ||||||||
| FaxNumber: | 3522738612 | ||||||||
| Practice Location | |||||||||
| Address1: | 1890 LPGA BLVD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | DAYTONA BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321177130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3862741744 | ||||||||
| FaxNumber: | 3862741644 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2005 | ||||||||
| LastUpdateDate: | 12/02/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | ME74466 | FL | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207R00000X | ME74466 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207L00000X | ME74466 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.