Healthcare Provider Details

I. General information

NPI: 1538001086
Provider Name (Legal Business Name): NATHAN ANDREW TUNELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 BLYTHE BLVD
CHARLOTTE NC
28203-5812
US

IV. Provider business mailing address

7227 W BLUEMOUND RD
MILWAUKEE WI
53213-3634
US

V. Phone/Fax

Practice location:
  • Phone: 704-355-3181
  • Fax: 704-355-7047
Mailing address:
  • Phone: 715-969-4634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: