Individual
DR. AMY BARTA WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1214 REYNOLDA RD, SUITE A, WINSTON SALEM, NC 27104-1151
(336) 723-2555
(336) 723-9007
Mailing address
1214 REYNOLDA RD, SUITE A, WINSTON SALEM, NC 27104-1151
(336) 723-2555
(336) 723-9007
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
9800734
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7910405
—
NC
Enumeration date
10/18/2007
Last updated
11/03/2010
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