Provider Demographics
NPI:1356377188
Name:DUNN, TAYLOR MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:MICHAEL
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 1:4444 MOUNTAINSIDE DR
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9560
Mailing Address - Country:US
Mailing Address - Phone:907-209-2667
Mailing Address - Fax:
Practice Address - Street 1:1801 SALMON CREEK LN
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7864
Practice Address - Country:US
Practice Address - Phone:907-586-2434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043708207P00000X
AKAK4865207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD48651Medicaid
AK8EC709Medicare PIN
AK8EC712Medicare PIN
AK8EC710Medicare PIN
AK8EC711Medicare PIN
WAH43177Medicare UPIN
WA8850785Medicare ID - Type Unspecified
AK8EC713Medicare PIN
AK8ED918Medicare PIN