Provider Demographics
NPI:1780648345
Name:NUNAN, PATRICK J (DPM)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:J
Last Name:NUNAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9104 MIDDLEGROUND RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4319
Mailing Address - Country:US
Mailing Address - Phone:912-927-8011
Mailing Address - Fax:912-927-8311
Practice Address - Street 1:9104 MIDDLEGROUND RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-4319
Practice Address - Country:US
Practice Address - Phone:912-927-8011
Practice Address - Fax:912-927-8311
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-2221213EP1101X, 213ES0000X, 213ES0103X
GAPOD001278213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003159203CMedicaid
OH0673703Medicaid
OH0695530001OtherMEDICARE NFC
OH1780648345OtherNPI
GA202I488627Medicare Oscar/Certification
OHT80683Medicare UPIN
OH0673703Medicaid