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Individual

DR. ANITA NEVYAS-WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
333 E CITY AVE, 2 BALA PLAZA, BALA CYNWYD, PA 19004-1501
(610) 668-2777
(610) 668-1509
Mailing address
333 E CITY AVE, 2 BALA PLAZA, BALA CYNWYD, PA 19004-1501
(610) 668-1192
(610) 668-1509

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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