Walls, Jeffrey Glen

Walls, Jeffrey Glen is an individual health care provider with primary practice located at 1918 Randolph Rd Ste 580 , Charlotte NC 28207-1116. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Walls, Jeffrey Glen can be contacted via phone (704) 384-9900.

Contact Information

Primary practice address
1918 Randolph Rd Ste 580 Charlotte NC 28207-1116
Phone: (704) 384-9900
Fax: (704) 384-9919
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 200300423 North Carolina
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 200300423 North Carolina
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 200300423 North Carolina

Profile Details

NPI number 1114987807
LBN Legal business name Walls, Jeffrey Glen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2006
Last updated Feb 20th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114987807 NPPES
South Carolina MEDICAID N0042B
South Carolina MEDICAID 89134K9

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