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Individual

NATHAN WAVLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 353-9515
Mailing address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 353-9515

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01084167A
IN
207P00000X
Emergency Medicine Physician
Primary
01084167B
IN

Other

Enumeration date
04/24/2017
Last updated
03/20/2026
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