Individual
DR. BENJAMIN MARK WAHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4500 FOREST PARK AVE, DEPT OTOLARYNGOLOGY, 5TH FL, SAINT LOUIS, MO 63108-2114
(314) 362-7509
(888) 452-4025
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-7509
(888) 452-4025
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
2025019752
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200062195
—
MO
Enumeration date
06/26/2017
Last updated
08/13/2025
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