Organization
MICHAEL WAHL MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J WAHL MD (PRESIDENT)
(727) 869-9300
Entity
Organization
Contact information
Practice address
13910 LAKESHORE BLVD, STE 140, HUDSON, FL 34667
(727) 869-9300
(727) 869-0636
Mailing address
13910 LAKESHORE BLVD, STE 140, HUDSON, FL 34667
(727) 869-9300
(727) 869-0636
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME62494
FL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280177900
—
FL
01
—
DG6180
PGBA
—
Enumeration date
09/12/2007
Last updated
12/17/2009
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