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NPI Code Detail

MEDICARE: WANDA J DUNGAN L.P.C.

MEDICARE: WANDA J DUNGAN L.P.C.
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
1101YP2500XProfessional Counselor0710001142VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1331729OTHERVATRICARE
22055241OTHERVACIGNA
3O81143OTHERVASOUTHERN HEALTH
4264159OTHERVAVALUE OPTIONS
5326873OTHERVAANTHEM
6326873OTHERVAHEALTHKEEPERS
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558323402
Entity Type Code : Individual
Provider Name (Legal Business Name) : WANDA J DUNGAN L.P.C.
Provider Business Mailing Address
First Line : 9228 GEORGE WASHINGTON MEMORIAL HWY
Second Line :
City : GLOUCESTER
State : VA
Zip : 23061-4162
Country : US
Telephone Number : 804-693-5068
Fax Number : 804-693-7407
Provider Business Practice Location Address
First Line : 414 MAIN ST
Second Line :
City : WARSAW
State : VA
Zip : 22572-4291
Country : US
Telephone Number : 804-333-3671
Fax Number : 804-333-3657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 07/09/2007

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1124410832 — BEATE ROSE L.P.C.
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