Individual
KENNETH WALLMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
306 WESTWOOD AVE, SUITE 401, HIGH POINT, NC 27262-4341
(336) 885-6168
(336) 885-8523
Mailing address
1701 WESTCHESTER DR, STE 850, HIGH POINT, NC 27262-7254
(336) 802-2400
(336) 802-2001
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
2006-01504
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5905908
—
NC
01
—
P00654539
RR MEDICARE
NC
Enumeration date
10/03/2006
Last updated
06/25/2009
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