Individual
ELISABETH MAY WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
565 COAL VALLEY RD, JEFFERSON HILLS, PA 15025-3703
(412) 267-6810
(412) 267-6817
Mailing address
565 COAL VALLEY RD, JEFFERSON HILLS, PA 15025-3703
(412) 267-6810
(412) 267-6817
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2085
WV
363A00000X
Physician Assistant
Primary
MA060530
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103600995
—
PA
01
—
14088083
CAQH
—
Enumeration date
08/23/2017
Last updated
02/08/2024
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