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General NPI Number Information
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NPI Number | 1245290121
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Entity Type | Individual
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Provider Name | ROBERT P WAHL M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 06/28/2010
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Provider Practice Location Address
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Address Line | 4201 SAINT ANTOINE ST 6G-UNIVERSITY HEALTH CENTER
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City | DETROIT
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State | MI
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Zip | 48201-2153
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Country | US
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Telephone | 313-993-2530
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Fax | 313-993-7703
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Provider Business Mailing Address
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Address Line | 4201 SAINT ANTOINE ST 6G-UNIVERSITY HEALTH CENTER
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City | DETROIT
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State | MI
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Zip | 48201-2153
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Country | US
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Telephone | 313-993-2530
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Fax | 313-993-7703
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 4301049741
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4301049741
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License Number State | MI
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