Wall, Mary Jean

Wall, Mary Jean is an individual health care provider with primary practice located at 1001 Lakeside Ave E Ste 1200 , Cleveland OH 44114-1172. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Wall, Mary Jean can be contacted via phone (216) 362-2000.

Contact Information

Primary practice address
1001 Lakeside Ave E Ste 1200 Cleveland OH 44114-1172
Phone: (216) 362-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 35059303W Ohio

Profile Details

NPI number 1265405237
LBN Legal business name Wall, Mary Jean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Nov 19th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265405237 NPPES
Ohio MEDICAID 0783022
Ohio Other P00286495
Ohio Other 000000339383
Ohio MEDICAID 1018989380001
Ohio MEDICAID 1018989380002
Ohio MEDICAID 1018989380003
Ohio MEDICAID 3810008142

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