Provider Demographics
NPI:1821582891
Name:WAHL, DEREK (PA-C)
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:
Last Name:WAHL
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:10950 CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8852
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10950 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8852
Practice Address - Country:US
Practice Address - Phone:919-756-6680
Practice Address - Fax:919-327-1649
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2024-01-25
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant