Stephen Jay Wall
M.D. | Pediatric Adolescent Medicine | Male
Stephen Jay Wall, M.D. is a Clyde, North Carolina based Pediatric doctor with medical specialization in
Pediatric Adolescent Medicine.
Current practice location of Stephen Jay Wall is
15 Facility Dr, Clyde, North Carolina - 28721-9438. He can be contacted on phone at
828-452-2211 and fax number 828-452-4421.
Stephen Jay Wall is a sole proprietor of his business.
NPI number (Unique professional ID) for Stephen Jay Wall is
1467454462 which was assigned by NPPES on 10 Aug, 2005 and it was last updated on 08 Jul, 2007.
Stephen Jay Wall license number is
38234 for Pediatrics Adolescent Medicine (2080A0000X) in North Carolina.
Stephen Jay Wall specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Stephen Jay Wall basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Stephen Jay Wall |
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| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Stephen Jay Wall address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 15 Facility Dr
Clyde, NC, 28721-9438
United States |
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| Phone Number : | 828-452-2211 |
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| Fax Number : | 828-452-4421 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1467454462 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 10 Aug, 2005 |
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| Last Updated On : | 08 Jul, 2007 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Stephen Jay Wall are as mentioned. Primary taxonomy code for Stephen Jay Wall, M.D. is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | 38234 | NC |
Legacy Identifiers:
Other legacy medical identifiers of Stephen Jay Wall such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 1270239 | Other | | UNITED HEALTHCARE |
| 8985406 | MEDICAID | NC | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 15 Facility Dr
Clyde, NC, 28721-9438
United States |
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| Phone Number : | 828-452-2211 |
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| Fax Number : | 828-452-4421 |
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Business Location:
Patients can refer following map for directions to
Stephen Jay Wall practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.