Provider Demographics
NPI:1821274259
Name:NUNEZ, ORLANDO E (DPM, MD)
Entity Type:Individual
Prefix:DR
First Name:ORLANDO
Middle Name:E
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:DPM, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W IRONWOOD DR
Mailing Address - Street 2:SUITE 131
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-1409
Mailing Address - Country:US
Mailing Address - Phone:208-666-0605
Mailing Address - Fax:208-666-0916
Practice Address - Street 1:101 W IRONWOOD DR
Practice Address - Street 2:SUITE 131
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-1409
Practice Address - Country:US
Practice Address - Phone:208-666-0605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3343213ES0103X
IDP-199213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID6176740001Medicare NSC