Individual
MARY JEAN WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 LAKESIDE AVE E STE 1200, CLEVELAND, OH 44114-1172
(216) 362-2000
Mailing address
108 W MAIN ST, PO BOX 305, BELLEVUE, OH 44811-1328
(419) 483-4543
(419) 483-0142
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35059303W
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000339383
ANTHEM
OH
05
—
0783022
—
OH
05
—
1018989380001
—
PA
05
—
1018989380002
—
PA
05
—
1018989380003
—
PA
05
—
3810008142
—
WV
01
—
P00286495
RAILROAD MC
OH
Enumeration date
02/09/2006
Last updated
11/19/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us