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Organization
ANTOINETTE W. WALL, M.D. PA
Active
Organization
ANTOINETTE W. WALL, M.D. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOINETTE W. WALL M.D PA (PRESIDENT)
(828) 684-3949
Entity
Organization
Contact information
Practice address
7 GLENN BRIDGE RD, STE D, ARDEN, NC 28704-3322
(828) 684-3949
(828) 684-2330
Mailing address
7 GLENN BRIDGE RD, STE D, ARDEN, NC 28704-3322
(828) 684-3949
(828) 684-2330
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
20857
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85383
BLUE CROSS/BLUE SHIELD
NC
05
—
8985383
—
NC
Enumeration date
04/28/2008
Last updated
04/28/2008
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