Walls, Jeffrey Glen
Walls, Jeffrey Glen is an individual health care provider with primary practice located at 1918 Randolph Rd Ste 580 , Charlotte NC 28207-1116. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Walls, Jeffrey Glen can be contacted via phone (704) 384-9900.Contact Information
Primary practice address
1918 Randolph Rd Ste 580
Charlotte NC 28207-1116
Phone: (704) 384-9900
Fax: (704) 384-9919
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 200300423 | North Carolina |
Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 200300423 | North Carolina |
Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 200300423 | North Carolina |
Profile Details
NPI number | 1114987807 |
---|---|
LBN Legal business name | Walls, Jeffrey Glen |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 25th, 2006 |
Last updated | Feb 20th, 2023 - 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 | 1114987807 | NPPES |
South Carolina | MEDICAID | N0042B | |
South Carolina | MEDICAID | 89134K9 |
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