Healthcare Provider Details

I. General information

NPI: 1033206032
Provider Name (Legal Business Name): FREDERICK A NUNES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 05/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 W WASHINGTON SQ FARM JOURNAL BUILDING, FL 4
PHILADELPHIA PA
19106-3500
US

IV. Provider business mailing address

230 W WASHINGTON SQ FARM JOURNAL BUILDING, FL 4
PHILADELPHIA PA
19106-3500
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-3561
  • Fax:
Mailing address:
  • Phone: 215-829-3561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD044459L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: