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Individual

DR. WALLACE C NUNLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2955 IVY RD, STE 304, CHARLOTTESVILLE, VA 22903-9353
(434) 243-2743
(434) 982-5109
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101027468
VA
207V00000X
Obstetrics & Gynecology Physician
38155
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1588671291
VA
05
8963646
NC
Enumeration date
08/02/2006
Last updated
11/02/2012
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