Wall, Robert T

Wall, Robert T is an individual health care provider with primary practice located at 9330 Medical Plaza Dr , Charleston SC 29406-9104. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Hematology & Oncology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Wall, Robert T can be contacted via phone (843) 847-3225.

Contact Information

Primary practice address
9330 Medical Plaza Dr Charleston SC 29406-9104
Phone: (843) 847-3225
Fax: (843) 847-3247
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 2011042 South Carolina
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 11042 South Carolina
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 11042 South Carolina

Profile Details

NPI number 1386627040
LBN Legal business name Wall, Robert T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 26th, 2005
Last updated May 9th, 2013 - about 11 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 1386627040 NPPES
South Carolina MEDICAID GP3633
South Carolina MEDICAID 110427

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