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NPI 1053393298

NPI 1053393298 : VALERIE A WOHL MD : NOGALES, AZ

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General NPI Number Information
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    NPI Number           |    1053393298
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    Entity Type          |    Individual 
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    Provider Name        |    VALERIE A WOHL MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/15/2005
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    Last Update Date     |    11/27/2017
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Provider Practice Location Address
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    Address Line         |    1852 N MASTICK WAY 
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    City                 |    NOGALES
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    State                |    AZ
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    Zip                  |    85621-1063
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    Country              |    US
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    Telephone            |    520-281-1550
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    Fax                  |    520-281-1112
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Provider Business Mailing Address
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    Address Line         |    1852 N MASTICK WAY 
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    City                 |    NOGALES
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    State                |    AZ
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    Zip                  |    85621-1063
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    Country              |    US
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    Telephone            |    520-281-1550
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    Fax                  |    520-281-1112
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    30707
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    License Number State |    AZ
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