Individual
BRIAN WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
163 VAN BUREN RD, CARIBOU, ME 04736-3567
(207) 498-6921
(207) 498-1392
Mailing address
PO BOX 40, CARIBOU, ME 04736-0040
(207) 498-2359
(207) 498-3947
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
015015
ME
Other
Enumeration date
03/14/2006
Last updated
11/09/2011
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