Individual
ROBERT W. WAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5301 VIRGINIA WAY, STE 300, BRENTWOOD, TN 37027-7541
(615) 221-4474
(615) 234-3774
Mailing address
5301 VIRGINIA WAY, STE 300, BRENTWOOD, TN 37027-7541
(615) 221-4474
(615) 234-3774
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
18591
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
9536
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000001589
TLC TENNCARE
TN
01
—
0053759
BLUE CROSS
TN
01
—
119361
UNISON TENNCARE
TN
05
—
1218779
—
OH
05
—
3041804
—
TN
05
—
64777030
—
KY
05
—
89063HH
—
NC
Enumeration date
09/28/2006
Last updated
07/08/2007
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