Healthcare Provider Details
I. General information
NPI: 1811458821
Provider Name (Legal Business Name): CHARLENE M DUNAWAY ALTAMIRANO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/31/2019
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2955 IVY RD STE 311
CHARLOTTESVILLE VA
22903-9353
US
IV. Provider business mailing address
3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE TN
37215-2691
US
V. Phone/Fax
- Phone: 434-924-2227
- Fax: 434-244-4503
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | 0101283379 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 0101283379 |
| License Number State | VA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | 77013 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: