Individual
BRIAN PATRICK WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
209 MILLSTONE DR, SUITE A, HILLSBOROUGH, NC 27278-8776
(919) 245-5400
Mailing address
PO BOX 1630, PINEHURST, NC 28370-1630
(910) 295-6007
(910) 215-0179
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
9801544
NC
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
9801544
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902265
—
NC
Enumeration date
09/17/2006
Last updated
07/22/2011
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