Individual
DR. ANITA NEVYAS-WALLACE
Active
Individual
DR. ANITA NEVYAS-WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD031809E
PA
207W00000X
Ophthalmology Physician
Primary
MD031809E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004407700
AETNA PPO
PA
05
—
0012162020001
—
PA
01
—
0110114000
KEYSTONE HEALTH PLAN
PA
01
—
0703757000
AMERIHEALTH HMO
NJ
01
—
10240MD031809E
HEALTH PARTNERS
PA
01
—
1054207
CIGNA HEALTH PLAN
NJ
01
—
180020274
MEDICARE TYPE UNSPECIFIED
PA
01
—
31236G
KEYSTONE MERCY HP
PA
01
—
483038
AETNA HMO
PA
01
—
483140
AETNA HMO
NJ
01
—
510550
PA BLUE SHIELD
PA
05
—
6211101
—
NJ
01
—
760539
PA BLUE SHIELD
NJ
01
—
912202
UNITED HEALTHCARE
PA
01
—
CA2279
MEDICARE TYPE UNSPECIFIED
PA
Enumeration date
11/30/2005
Last updated
07/10/2008
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