STEPHEN JAY WALL M.D. - NPI 1467454462 - Pediatrics in Clyde, NC

Q: What is Stephen Wall's NPI number?

The NPI number for Stephen Wall is 1467454462. It was assigned to this individual provider in the NPPES registry on August 10, 2005.

Q: What is Stephen Wall's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Q: When was this NPI record last updated?

The NPPES record for Stephen Wall was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Stephen Jay Wall M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STEPHEN JAY WALL M.D. (NPI 1467454462) is an individual adolescent medicine provider in Clyde, North Carolina, licensed in North Carolina (38234) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1467454462

Entity TypeIndividualMale

Primary Taxonomy2080A0000X

Provider Legal NameSTEPHEN JAY WALLCredential: M.D.

Location Address15 FACILITY DRClyde, NC 28721-9438

Mailing Address15 Facility DrClyde, NC 28721-9438 · (828) 452-2211 · Fax (828) 452-4421

Phone(828) 452-2211

Fax(828) 452-4421

Sole ProprietorNo

Enumeration DateAugust 10, 2005

Last NPPES UpdateJuly 8, 2007

✔ NPI 1467454462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080A0000X

License✔ Licensed in NC · 38234

Definition

A pediatrician who 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.

15 FACILITY DR, Clyde, NC 28721

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