Wall, Wendell A

Wall, Wendell A is an individual health care provider with primary practice located at 1720 Highway 59 S , Thief River Falls MN 56701-4331. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Wall, Wendell A can be contacted via phone (218) 681-4747.

Contact Information

Primary practice address
1720 Highway 59 S Thief River Falls MN 56701-4331
Phone: (218) 681-4747
Fax: (218) 683-2595
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 28024 Minnesota

Profile Details

NPI number 1700812757
LBN Legal business name Wall, Wendell A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Dec 13th, 2011 - about 13 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 1700812757 NPPES
Minnesota Other 068G5WA MNBS #
Minnesota MEDICAID 002767700 MNBS #
Minnesota MEDICAID 14419 MNBS #
Minnesota Other 2395 MNBS #
Minnesota Other 20522 MNBS #
Minnesota Other 769233 MNBS #
Minnesota Other DA9021015637 MNBS #
Minnesota Other HP19559 MNBS #
Minnesota Other 142078 MNBS #
Minnesota Other ND200109 MNBS #
Minnesota Other 0701809 MNBS #
Minnesota Other 24343 MNBS #
Minnesota Other 45G58WA MNBS #
Minnesota Other 0703790 MNBS #

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