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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