Provider Demographics
NPI:1134416993
Name:PATRICK J NUNAN DPM PLLC
Entity type:Organization
Organization Name:PATRICK J NUNAN DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:NUNAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:304-523-3338
Mailing Address - Street 1:3135 16TH STREET RD STE 15
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-5247
Mailing Address - Country:US
Mailing Address - Phone:304-523-3338
Mailing Address - Fax:304-522-1000
Practice Address - Street 1:3135 16TH STREET RD STE 15
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-5247
Practice Address - Country:US
Practice Address - Phone:304-523-3338
Practice Address - Fax:304-522-1000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV00203213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty