Individual
WENDELL A WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1720 HIGHWAY 59 S, THIEF RIVER FALLS, MN 56701-4331
(218) 681-4747
(218) 683-2595
Mailing address
1720 HIGHWAY 59 S, THIEF RIVER FALLS, MN 56701-4331
(218) 681-4747
(218) 683-2595
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
28024
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002767700
—
MN
01
—
068G5WA
MNBS #
MN
01
—
0701809
MEDICA #
ND
01
—
0703790
MEDICA #
MN
01
—
142078
UCARE #
MN
05
—
14419
—
MN
01
—
20522
NDBS #
ND
01
—
2395
NDBS #
ND
01
—
24343
NDBS #
MN
01
—
45G58WA
MNBS #
ND
01
—
769233
AMERICA'S PPO/ARAZ #
MN
01
—
DA9021015637
PREFERRED ONE #
MN
01
—
HP19559
HEALTHPARTNERS #
MN
01
—
ND200109
LHS #
ND
Enumeration date
06/23/2006
Last updated
12/13/2011
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