Stephen Jay Wall in Clyde - Adolescent Medicine
Stephen Jay Wall - NPI 1467454462
Stephen Jay Wall is a Adolescent Medicine in Clyde, North Carolina. Stephen Jay Wall practices all healthcare services and medical treatments related to Adolescent Medicine. The NPI Number for Stephen Jay Wall is 1467454462. The last update date is 2007-07-08.
Stephen Jay Wall's current location address is 15 Facility Dr, Clyde, North Carolina. You can contact this provider via phone number 8284522211 and fax number 8284524421. The mailing address for Stephen Jay Wall is 15 Facility Dr, Clyde, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stephen Jay Wall |
|---|---|
| Address | 15 Facility Dr, Clyde, North Carolina |
| Phone Number | 8284522211 |
| Fax Number | 8284524421 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1467454462 |
|---|---|
| Provider Enumeration Date | 2005-08-10 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 15 Facility Dr |
|---|---|
| City | Clyde |
| State | North Carolina (NC) |
| Post Code | 287219438 |
| Phone Number | 8284522211 |
| Fax Number | 8284524421 |
Provider's Primary Taxonomy Detail
| Speciality | Adolescent Medicine |
|---|---|
| Taxonomy | 2080A0000X |
| Licence No | 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. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1270239 | UNITED HEALTHCARE | ||
| 8985406 | NC | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Stephen Jay Wall by the Centers for Medicare & Medicaid Services?
The Stephen Jay Wall has been assigned the NPI (National Provider Identifier) 1467454462. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Where is the Stephen Jay Wall located?
The Stephen Jay Wall is located at 15 Facility Dr, Clyde, NC 287219438.
What is Stephen Jay Wall's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Stephen Jay Wall is Adolescent Medicine, and the taxonomy classification code that categorizes this area of expertise is 2080A0000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1467454462 to Stephen Jay Wall?
The Centers for Medicare & Medicaid Services assigned the 1467454462 to Stephen Jay Wall on 2005-08-10.
When was the information related to Stephen Jay Wall most recently updated or refreshed?
The details pertaining to the Stephen Jay Wall, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-08.