Individual
BRIAN PATRICK WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MS
Contact information
Practice address
2728 SUNSET BLVD STE 300, WEST COLUMBIA, SC 29169-4815
(803) 744-4940
(803) 744-4938
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37064
SC
207RC0000X
Cardiovascular Disease Physician
37064
SC
207RI0011X
Interventional Cardiology Physician
Primary
37064
SC
Other
Enumeration date
06/20/2007
Last updated
11/11/2020
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