Individual
DR. LEONARD LEWIS WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, STE 13C, SAINT LOUIS, MO 63110-1032
(314) 747-1402
(314) 362-3328
Mailing address
660 S EUCLID AVE, C B 8064, SAINT LOUIS, MO 63110-1010
(314) 747-1402
(314) 362-3328
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2002005866
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080010217
—
MO
Enumeration date
07/17/2006
Last updated
01/30/2014
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