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NPI Code Detail

MEDICARE: DR. LOREN NUNLEY M.D.

MEDICARE: DR. LOREN NUNLEY M.D.
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
1207RI0200XInfectious Disease Physician69069-20WI
2207RI0200XInfectious Disease Physician036-1538190IL

General Provider Information

NPI Number : 1689060188
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOREN NUNLEY M.D.
Provider Business Mailing Address
First Line : 8701 W WATERTOWN PLANK RD # HUBA8143
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-3548
Country : US
Telephone Number : 410-980-3477
Fax Number : 414-955-0097
Provider Business Practice Location Address
First Line : 13755 CICERO AVE
Second Line :
City : CRESTWOOD
State : IL
Zip : 60418-1824
Country : US
Telephone Number : 888-220-6432
Fax Number : 630-654-4253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2015
Last Update Date : 12/28/2021

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Directions to “ DR. LOREN NUNLEY M.D.” Practice Location

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