Provider Demographics
NPI:1003843038
Name:WAHL, STEPHEN MARSHALL (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MARSHALL
Last Name:WAHL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3920 BEE RIDGE RD
Mailing Address - Street 2:BUILDING F, SUITE B
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1207
Mailing Address - Country:US
Mailing Address - Phone:941-923-5491
Mailing Address - Fax:941-924-4751
Practice Address - Street 1:3920 BEE RIDGE RD
Practice Address - Street 2:BUILDING F, SUITE B
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1207
Practice Address - Country:US
Practice Address - Phone:941-923-5491
Practice Address - Fax:941-924-4751
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2018-01-01
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Provider Licenses
StateLicense IDTaxonomies
FLME66624207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
F63770Medicare UPIN
25560YMedicare ID - Type Unspecified