Basic Information
| Provider Information | |||||||||
| NPI: | 1811059421 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNN | ||||||||
| FirstName: | BRAD | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 EAST JEFFERSON STREET PPQA MEDICARE COMP UNIT 6 | ||||||||
| Address2: | KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208524908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018166660 | ||||||||
| FaxNumber: | 3018166308 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 2ND ST NE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200028100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2023463000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2006 | ||||||||
| LastUpdateDate: | 12/23/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | OP744 | DC | Y | Eye and Vision Services Providers | Optometrist | 152W00000X | TA1334 | MD | N | Eye and Vision Services Providers | Optometrist |
No ID Information.