Provider Information for 1497934897
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STEPHEN MICHAEL WAHL M.D.
Gender: Male
NPI: 1497934897
Last Updated: 2018-09-19
Certification Date:
Certification Date:
Details
Name | Value | ||||||||||||||||
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NPI | 1497934897 | ||||||||||||||||
Enumeration Date | 2007-11-01 | ||||||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||||||
Sole Proprietor | YES | ||||||||||||||||
Status | Active | ||||||||||||||||
Mailing Address | 265 N BINKLEY ST SOLDOTNA, AK 99669-7523 United States Phone: 907-262-9341 | Fax:907-262-1545 | ||||||||||||||||
Primary Practice Address | 265 N BINKLEY ST SOLDOTNA, AK 99669-7523 United States Phone: 907-262-9341 | Fax:907-262-1545 | ||||||||||||||||
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