Wall, Michelle Deanna

Wall, Michelle Deanna is an individual health care provider with primary practice located at 348 N South St , Mount Airy NC 27030-3532. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Wall, Michelle Deanna can be contacted via phone (336) 786-6945.

Contact Information

Primary practice address
348 N South St Mount Airy NC 27030-3532
Phone: (336) 786-6945
Fax: (336) 789-5782
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 103078 North Carolina

Profile Details

NPI number 1619195302
LBN Legal business name Wall, Michelle Deanna
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2007
Last updated Jun 8th, 2009 - about 16 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 1619195302 NPPES
North Carolina Other 2291842C MEDICARE GROUP/ORGANIZATION PTAN
North Carolina Other 2759201 MEDICARE GROUP/ORGANIZATION PTAN

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