| Bc Wall Medical Group Pa | |
|
1574 Union Road A Gastonia NC 28054-5633 | |
| (704) 866-4607 | |
| (704) 866-5292 |
| Full Name | Bc Wall Medical Group Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1574 Union Road, Gastonia, North Carolina |
| Authorized Official Name and Position | Brian K Wall (PRESIDENT) |
| Authorized Official Contact | 7048664607 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bc Wall Medical Group Pa 557 Cameron Pointe Ln Belmont NC 28012-6702 Ph: (704) 825-2363 | Bc Wall Medical Group Pa 1574 Union Road A Gastonia NC 28054-5633 Ph: (704) 866-4607 |
| NPI Number | 1164610580 |
|---|---|
| Provider Enumeration Date | 10/10/2007 |
| Last Update Date | 10/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164610580 | NPI | - | NPPES |
| 891057P | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 9701190 (North Carolina) | Primary |
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