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MARY INEZ NUNCHUCK D.O. NPI 1316028616


NPI Information

NPI: 1316028616
Provider Name: MARY INEZ NUNCHUCK, D.O.
Classification: Psychiatry & Neurology - 2084P0802X
Entity Type: Individual

Specialization: Addiction Psychiatry

PECOS Registration: Yes

Address:
1717 TAYLOR AVE
RACINE, WI
ZIP 53403
Phone: (262) 638-6744
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Mary Inez Nunchuck, D.O. is an addiction psychiatry psychiatry neurology in Racine, WI. The provider is addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. Mary Inez Nunchuck, D.O. NPI is 1316028616. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1717 TAYLOR AVE
RACINE, WI
ZIP 53403-405
Phone: (262) 638-6744
Fax: (262) 638-6540

The NPI 1316028616 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 10/17/2006 and was last updated on 7/7/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0802XPsychiatry & NeurologyAddiction Psychiatry377260021WISCONSINYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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