HAVEN N WALL JR MD INC (NPI# 1710013081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710013081 |
| Entity Type | Organization |
| Organization Name | HAVEN N WALL JR MD INC |
| Practice Address |
Rr 2 Box 171c Lewisburg WV 24901-9318 |
| Mailing Address |
Po Box 1046 Lewisburg WV 24901-4046 |
| Practice Telephone | 3046456083 |
| Mailing Telephone | 3046456083 |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2010-05-14 |
| Authorized Official Name | HAVEN N WALL (PRESIDENT) |
| Authorized Official Telephone | 3046456083 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
12141 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0087282000 | 05 |
| Street Address |
RR 2 BOX 171C |
| City | LEWISBURG |
| State | WV |
| Zip Code | 24901-9318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013912187 | Haven N Wall Jr. | Internal Medicine | Rr 2 Box 171c, Lewisburg, WV 24901-9318 | 2005-06-16 |
| 1437184462 | Mary Lou Fragile Do | Family Medicine | Rr 2 Box 171c, Greyrock Prof Park, Lewisburg, WV 24901 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093940 | Amy Lu Moss | Technician | 254 Moss D Lane, Fairlea, WV 24901 | 2020-11-04 |
| 1083212377 | Miranda Shope | Technician | 814 Maple Ave., Lewisburg, WV 24901 | 2020-10-09 |
| 1184235830 | Carol E Beasley | Technician | 147 Windy Hill Road, Lewisburg, WV 24901 | 2020-08-14 |
| 1790317782 | Preston Dyer Modlin | Psychologist | 635 Church Street, Lewisburg, WV 24901 | 2020-02-07 |
| 1437780269 | Healthcare 360 Pllc | Family Medicine | 208 Dawkins Drive, Lewisburg, WV 24901 | 2020-01-30 |
| 1821655390 | Janet Lee Kowalsky | Student in an Organized Health Care Education/Training Program | 1464 N Jefferson St., Lewisburg, WV 24901 | 2019-05-21 |
| 1598321192 | Ali Yousaf | Student in an Organized Health Care Education/Training Program | 400 North Jefferson, Lewisburg, WV 24901 | 2019-05-20 |
| 1770053308 | Micheala Renae Taylor | Student in an Organized Health Care Education/Training Program | 1464 North Jefferson Street, Lewisburg, WV 24901 | 2018-11-27 |
| 1659840486 | Maggie King Clendenen | Nurse Practitioner | 454 Bell Drive, Lewisburg, WV 24901 | 2018-11-22 |
| 1861979312 | Vincent Morra | Student in an Organized Health Care Education/Training Program | 1464 N Jefferson St, Lewisburg, WV 24901 | 2018-07-26 |
| Find all providers in zip 24901 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417153172 | Greenbrier Vmc LLC | Internal Medicine | Rr 2 Box 171-c, Greyrock Professional Park, Lewisburg, WV 24901-9318 | 2007-06-21 |
| 1790890879 | Thomas Walter Von Dohlen | Internal Medicine | 157 Skylar Dr, Lewisburg, WV 24901-9359 | 2006-08-20 |
| 1013912187 | Haven N Wall Jr. | Internal Medicine | Rr 2 Box 171c, Lewisburg, WV 24901-9318 | 2005-06-16 |
| 1699770651 | Brian G Richards | Internal Medicine | 400 N Jefferson St, Lewisburg, WV 24901 | 2005-06-16 |
| 1487658894 | Douglas P Bosack | Internal Medicine | Rr 2 Box 171, Lewisburg, WV 24901-9318 | 2005-06-13 |
| 1184896755 | Petra S Lynch | Internal Medicine | 3 Hospital Dr, Suite 100, Lewisburg, PA 17837-9362 | 2008-03-24 |
| 1114128261 | Anuradha Tunuguntla | Internal Medicine | 1 Hospital Dr, Lewisburg, PA 17837-9350 | 2007-05-29 |
| 1922109545 | Heart Center Inc | Internal Medicine | 157 Skylar Dr, Lewisburg, WV 24901-9359 | 2006-09-26 |
| 1104845395 | John M Pfeifer | Internal Medicine | 3 Hospital Dr, Suite 100, Lewisburg, PA 17837-9362 | 2006-07-19 |
| 1710903760 | Dennis R Smith | Internal Medicine | 131 Jpm Rd, Lewisburg, PA 17837-9309 | 2006-07-14 |
| Find all providers in LEWISBURG | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.