Healthcare Provider Details

I. General information

NPI: 1497934897
Provider Name (Legal Business Name): STEPHEN MICHAEL WAHL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 439
METLAKATLA AK
99926-0439
US

IV. Provider business mailing address

PO BOX 439
METLAKATLA AK
99926-0439
US

V. Phone/Fax

Practice location:
  • Phone: 907-886-4742
  • Fax: 907-886-5831
Mailing address:
  • Phone: 907-886-4742
  • Fax: 907-886-5831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberAA 3683
License Number StateAK
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAA 3683
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: