Individual
WALLY STURGIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
201 TABERNACLE RD, BLACK MOUNTAIN, NC 28711-2526
(828) 669-3496
Mailing address
14 HIGH VALLEY ESTATES DR, ALEXANDER, NC 28701-9726
(828) 683-4437
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
100651
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100651
MEDICAL BOARD NUMBER
NC
Enumeration date
03/29/2007
Last updated
07/08/2007
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