Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME17550 | FL |
N | 208600000X | Surgeon | ME17550 | FL |
N | 2082S0105X | Plastic Hand Surgeon | ME17550 | FL |
NPI | 1861947996 |
---|---|
Provider Name | Dr. Harlan Ira Wald |
First Address | Fort Lauderdale, FL 33316-1419 |
Second Address | Fort Lauderdale, FL 33316-1419 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2016 |
Last Update Date | 18/08/2016 |