Provider Demographics
NPI:1316927767
Name:TUNSTALL, JUNE REBECCA (MD)
Entity type:Individual
Prefix:DR
First Name:JUNE
Middle Name:REBECCA
Last Name:TUNSTALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 COLONIAL TRL E
Mailing Address - Street 2:PO BOX 354
Mailing Address - City:SURRY
Mailing Address - State:VA
Mailing Address - Zip Code:23883-9997
Mailing Address - Country:US
Mailing Address - Phone:757-294-3188
Mailing Address - Fax:757-294-0108
Practice Address - Street 1:401-405 HOPEWELL STREET
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2817
Practice Address - Country:US
Practice Address - Phone:804-458-6396
Practice Address - Fax:804-458-4934
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101029877207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA080003465OtherMEDICARE
VA5679818Medicaid
VA5650569Medicaid
VA080000318OtherMEDICARE
VA080000318OtherMEDICARE
VA5679818Medicaid
VAB09065Medicare UPIN