Wall, Susan Dale
Wall, Susan Dale is an individual health care provider with primary practice located at 521 Westbury Dr Ste 2 , Iowa City IA 52245-2727. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Procedural Dermatology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Wall, Susan Dale can be contacted via phone (319) 339-3872.Contact Information
Primary practice address
521 Westbury Dr Ste 2
Iowa City IA 52245-2727
Phone: (319) 339-3872
Fax: (319) 339-3874
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | 28400 | Iowa |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 28400 | Iowa |
Profile Details
| NPI number | 1962480970 |
|---|---|
| LBN Legal business name | Wall, Susan Dale |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2006 |
| Last updated | Jun 30th, 2022 - about 2 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 | 1962480970 | NPPES |
| Iowa | MEDICAID | 0079301 |
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