Basic Information
| Provider Information | |||||||||
| NPI: | 1366414971 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WAHL | ||||||||
| FirstName: | NAOMI | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 801143 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641801143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733315583 | ||||||||
| FaxNumber: | 5733315079 | ||||||||
| Practice Location | |||||||||
| Address1: | 211 SAINT FRANCIS DR | ||||||||
| Address2: | |||||||||
| City: | CAPE GIRARDEAU | ||||||||
| State: | MO | ||||||||
| PostalCode: | 637035049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733315511 | ||||||||
| FaxNumber: | 5733315512 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2006 | ||||||||
| LastUpdateDate: | 02/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VM0101X | 2012016003 | MO | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 361R1WA | 01 | MN | BLUE CROSS | OTHER | 361R1WA | 01 | MN | CC SYSTEMS/BLUE PLUS | OTHER | HP24640 | 01 | SD | HEALTHPARTNERS | OTHER | 0503706 | 05 | IA | MEDICAID | 4260 | 01 | SD | DAKOTACARE | OTHER | 4995764 | 01 | SD | BLUE CROSS | OTHER | 6630360 | 05 | SD | MEDICAID | 1366414971 | 05 | MO | MEDICAID | 10025040700 | 05 | NE | MEDICAID | 57105AD02 | 01 | SD | WPS TRICARE | OTHER | 939216500 | 05 | MN | MEDICAID | 283761017548 | 01 | SD | PREFERRED ONE | OTHER | 768489 | 01 | SD | ARAZ/ AMERICA'S PPO | OTHER | 0703687 | 01 | SD | MEDICA | OTHER | 23737 | 01 | SD | MIDLANDS CHOICE | OTHER | 25421 | 01 | SD | SANFORD HEALTH PLAN | OTHER | 38022 | 01 | IA | BLUE CROSS | OTHER |