Provider Demographics
NPI:1952366064
Name:TUNNER, WILLIAM S (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:TUNNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9105 STONY POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1979
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9105 STONY POINT PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1979
Practice Address - Country:US
Practice Address - Phone:804-287-1030
Practice Address - Fax:804-288-3529
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101 014616208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA76508599OtherTRICARE
VA790561OtherAETNA HMO
VA212763OtherCIGNA
VACA6752OtherRAILROAD MEDICARE GROUP #
VA1900517OtherUNITED HEALTHCARE
VA310027OtherALLIANCE
VA4063843OtherAETNA PPO
VA59332OtherSOUTHERN HEALTH
VAC04057OtherMEDICARE GROUP #
VA080250000-00OtherQUALCHOICE
VA42608OtherCARENET
VA45736OtherSENTARA FAMILY CARE
VA1900517OtherUNITED HEALTHCARE