Provider Demographics
NPI:1871524694
Name:DUNN, GEOFFREY PARKER (MD)
Entity type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:PARKER
Last Name:DUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 STATE ST STE 16
Mailing Address - Street 2:REGIONAL HEALTH SERVICES
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1341
Mailing Address - Country:US
Mailing Address - Phone:814-877-7100
Mailing Address - Fax:814-877-2939
Practice Address - Street 1:201 STATE ST
Practice Address - Street 2:HAMOT FACULTY SPECIALISTS
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16550-0002
Practice Address - Country:US
Practice Address - Phone:814-877-4922
Practice Address - Fax:814-877-3622
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD30831E2086H0002X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086H0002XAllopathic & Osteopathic PhysiciansSurgeryHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA990014795OtherRR MEDICARE
OH0816862OtherOH MEDICAL ASSISTANCE
PA0009765810003Medicaid
PA2586652OtherAETNA
NY00991846OtherNY MEDICAL ASSISTANCE
PA212530OtherUPMC
NY00027703101OtherUNIVERA
PA96523OtherBLUE SHIELD
PA1542249OtherGATEWAY
PA97356OtherUNISON
C29811Medicare UPIN
PA990014795OtherRR MEDICARE