MEDICARE: NUNEHE FITNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center		DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215251491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUNEHE FITNESS

Provider Business Mailing Address
First Line	:	2639 CONNECTICUT AVE NW
Second Line	:	SUITE 251
City	:	WASHINGTON
State	:	DC
Zip	:	20008-1537
Country	:	US
Telephone Number	:	202-588-8056
Fax Number	:

Provider Business Practice Location Address
First Line	:	2639 CONNECTICUT AVE NW
Second Line	:	SUITE 251
City	:	WASHINGTON
State	:	DC
Zip	:	20008-1537
Country	:	US
Telephone Number	:	202-588-8056
Fax Number	:

Authorized Official
Title or Position	:	OWNER, HEALTH CONSULTANT
Name	:	MR. GERALD ROGER DAVIS
Credential	:	M.A.,CPFT
Telephone Number	:	202-588-8056

Provider Enumeration Date	:	03/17/2010
Last Update Date	:	03/17/2010

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Directions to “NUNEHE FITNESS ” Practice Location

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