Individual
DR. COLLEEN ANN WUNDERLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., MSC
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2007-00969
NC
208100000X
Physical Medicine & Rehabilitation Physician
46317
MN
2081P0010X
Pediatric Rehabilitation Medicine Physician
0101238304
VA
2081P0010X
Pediatric Rehabilitation Medicine Physician
2007-00969
NC
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
40616
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1458X
NCBCBS
NC
05
—
5907606
—
NC
05
—
N69007
—
SC
Enumeration date
03/01/2007
Last updated
07/06/2020
Update your record
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