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Individual

ELMER F WAHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4881 SUGAR MAPLE DR, 88 MDOS/SGOPC, WRIGHT PATTERSON AFB, OH 45433-5546
(937) 257-9700
Mailing address
4881 SUGAR MAPLE DR, 88 MDOS/SGOPC, WRIGHT PATTERSON AFB, OH 45433-5546
(937) 257-9700

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0924297
MI
207Q00000X
Family Medicine Physician
Primary
35038148
OH
207Q00000X
Family Medicine Physician
39131
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0308232
OH
05
64094527
KY
Enumeration date
05/31/2006
Last updated
07/08/2007
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