Provider Demographics
NPI:1548481542
Name:NUNAMAKER, DOUGLAS AARON (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:AARON
Last Name:NUNAMAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10500 E BERKELEY SQUARE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-6816
Mailing Address - Country:US
Mailing Address - Phone:316-260-6454
Mailing Address - Fax:316-260-8479
Practice Address - Street 1:10500 E BERKELEY SQUARE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-6816
Practice Address - Country:US
Practice Address - Phone:316-260-6454
Practice Address - Fax:316-260-8479
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0432612207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine