Individual
IQBAL WALIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 WILLIAM ST, NEWFANE, NY 14108-1026
(716) 778-5071
Mailing address
PO BOX 281562, ATLANTA, GA 30384-1562
(904) 482-1070
(904) 482-1077
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
131516-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000523881002
BLUE SHIELD
NY
05
—
01590707/04
—
NY
Enumeration date
07/20/2006
Last updated
07/09/2007
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