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General NPI Number Information
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NPI Number | 1558700716
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Entity Type | Individual
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Provider Name | NATHAN MATTHEW WNUK M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 2400 S AVENUE A
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City | YUMA
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State | AZ
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Zip | 85364-7170
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Country | US
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Telephone | 928-336-1759
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Fax | 928-336-1758
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Provider Business Mailing Address
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Address Line | 1911 HOLCOMBE BLVD APT 906
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City | HOUSTON
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State | TX
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Zip | 77030-4183
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 57732
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | R7145
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 57732
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License Number State | AZ
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