Provider Demographics
NPI:1427078955
Name:NUNLEY, MARSHA KAY (MD)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:KAY
Last Name:NUNLEY
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 1:300 LAKESIDE DR STE 202
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3654
Mailing Address - Country:US
Mailing Address - Phone:510-893-3907
Mailing Address - Fax:510-893-3987
Practice Address - Street 1:300 LAKESIDE DR STE 202
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3654
Practice Address - Country:US
Practice Address - Phone:510-893-3907
Practice Address - Fax:510-893-3987
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0696207R00000X
CAC50005207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF31716Medicare UPIN