Provider Demographics
NPI:1932536232
Name:DUNN, EPHRAIM (D O)
Entity type:Individual
Prefix:DR
First Name:EPHRAIM
Middle Name:
Last Name:DUNN
Suffix:
Gender:M
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 W LEHIGH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-2664
Mailing Address - Country:US
Mailing Address - Phone:264-866-7211
Mailing Address - Fax:305-698-6536
Practice Address - Street 1:2101 W LEHIGH AVE STE A
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132
Practice Address - Country:US
Practice Address - Phone:264-866-7211
Practice Address - Fax:305-698-6536
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207Q000X207Q00000X
PAOS017795207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine