Basic Information
| Provider Information | |||||||||
| NPI: | 1427030956 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNTEMAN | ||||||||
| FirstName: | EDWIN | ||||||||
| MiddleName: | DALE | ||||||||
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| Credential: | MD, MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1300 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | RUSHVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461731116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7659324111 | ||||||||
| FaxNumber: | 7659327062 | ||||||||
| Practice Location | |||||||||
| Address1: | 1310 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | RUSHVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461731116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7659327600 | ||||||||
| FaxNumber: | 7659327609 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2005 | ||||||||
| LastUpdateDate: | 08/29/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | R8N65 | MO | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207LP2900X | 01079428A | IN | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 208VP0014X | R8N65 | MO | N | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | 208VP0014X | 01079428A | IN | Y | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
No ID Information.