Organization
MPWALL, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN PURDY WALL M.D. (DOCTOR/OWNER)
(970) 879-3200
Entity
Organization
Contact information
Practice address
940 CENTRAL PARK DR, SUITE 207, STEAMBOAT SPRINGS, CO 80487-8816
(970) 879-3200
(970) 879-4608
Mailing address
940 CENTRAL PARK DR, SUITE 207, STEAMBOAT SPRINGS, CO 80487-8816
(970) 879-3200
(970) 879-4608
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01370105
—
CO
Enumeration date
10/26/2007
Last updated
08/26/2009
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