Individual
DR. MICHAEL J WAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13910 LAKESHORE BLVD, SUITE 140, HUDSON, FL 34667-1481
(727) 869-9300
(727) 869-0636
Mailing address
13910 LAKESHORE BLVD, SUITE 140, HUDSON, FL 34667-1481
(727) 869-9300
(727) 869-0636
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME0062494
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002224500
—
FL
05
—
280177900
—
FL
05
—
370704100
—
FL
01
—
P00444360
PGBA - RAILROAD MEDICARE
—
Enumeration date
10/13/2006
Last updated
10/23/2012
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