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NPI Code Detail

MEDICARE: DR. CHRISTOPHER D WAHL AUD CCCA

MEDICARE: DR. CHRISTOPHER D WAHL AUD CCCA
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
1237600000XAudiologist-Hearing Aid Fitter
2231H00000XAudiologistDA1806AZ

General Provider Information

NPI Number : 1376679621
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER D WAHL AUD CCCA
Provider Business Mailing Address
First Line : 36305 N GANTZEL RD STE 104
Second Line :
City : SAN TAN VALLEY
State : AZ
Zip : 85140-7326
Country : US
Telephone Number : 804-284-6004
Fax Number :
Provider Business Practice Location Address
First Line : 5750 W THUNDERBIRD RD STE F600
Second Line :
City : GLENDALE
State : AZ
Zip : 85306-4667
Country : US
Telephone Number : 602-863-4203
Fax Number : 602-863-4216
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 04/24/2024

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