Individual
SAMUEL ISAAC WAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 MEMORIAL DR, PINEHURST, NC 28374-8707
(910) 295-4400
(910) 295-2810
Mailing address
30 MEMORIAL DR, PINEHURST, NC 28374-8707
(910) 295-4400
(910) 295-2810
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2006-01411
NC
2085R0204X
Vascular & Interventional Radiology Physician
Primary
2006-01411
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14263
BCBS NC
NC
05
—
5904644
—
NC
Enumeration date
08/01/2006
Last updated
06/09/2023
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