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Individual

WAEIL A NUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
21 HIGHLAND AVE SE, SUITE 100, ROANOKE, VA 24013-2201
(540) 344-9213
(540) 345-7559
Mailing address
21 HIGHLAND AVE SE, SUITE 100, ROANOKE, VA 24013-2201
(540) 344-9213
(540) 345-7559

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101243880
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13695
BLUE CROSS
Enumeration date
08/26/2005
Last updated
11/11/2020
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