Individual
DR. THOMAS CRAVEN WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1126 N CHURCH ST, SUITE 300, GREENSBORO, NC 27401-1000
(336) 547-1700
Mailing address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 832-7000
(336) 851-8427
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
28097
NC
207RC0000X
Cardiovascular Disease Physician
Primary
28097
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2298
PARTNERS MEDICARE
NC
01
—
33586
MEDCOST
NC
01
—
4245049
AETNA
NC
01
—
85392
BCBS NC
NC
05
—
8985392
—
NC
Enumeration date
05/11/2006
Last updated
08/26/2019
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