Wald, Mark S
Wald, Mark S is an individual health care provider with primary practice located at 6 Jungermann Cir Suite 210, Saint Peters MO 63376-1621. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Wald, Mark S can be contacted via phone (636) 441-6056.Contact Information
Primary practice address
6 Jungermann Cir Suite 210
Saint Peters MO 63376-1621
Phone: (636) 441-6056
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | R8691 | Missouri |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 036081636 | Illinois |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207RS0012X | R8691 | Missouri |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207RS0012X | 036081636 | Illinois |
Profile Details
| NPI number | 1194716688 |
|---|---|
| LBN Legal business name | Wald, Mark S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Jul 31st, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194716688 | NPPES |
| Missouri | MEDICAID | 201751005 | |
| Missouri | Other | 290009909 | |
| Missouri | Other | 29007538 |
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