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NPI Code Detail

MEDICARE: WALLY FOLAD M.D.

MEDICARE: WALLY FOLAD M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician49722KY
2208M00000XHospitalist Physician17389NV
3207R00000XInternal Medicine Physician50944TN
4208M00000XHospitalist Physician50944TN
5207R00000XInternal Medicine Physician17389NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P01505983OTHERTNRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
36039779OTHERTNBLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number : 1326331893
Entity Type Code : Individual
Provider Name (Legal Business Name) : WALLY FOLAD M.D.
Provider Business Mailing Address
First Line : 300 20TH AVE N STE 403
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-5180
Country : US
Telephone Number : 615-284-7224
Fax Number : 615-284-7501
Provider Business Practice Location Address
First Line : 6166 N DURANGO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-3912
Country : US
Telephone Number : 725-223-4100
Fax Number : 865-560-7110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2011
Last Update Date : 11/12/2024

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