Active NPI
Harlan Ira Wald, M.D.
- Legal Medicine (M.D./D.O.) Physician
- Fort Lauderdale, FL
National Provider Identifier
1861947996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine (M.D./D.O.) Physician
- License
- ME17550
- Practice address
- 1501 SE 10TH St
Fort Lauderdale, FL 33316-1419 - Phone
- (954) 523-7204
- NPI assigned
- Aug 18, 2016
- Last updated
- Aug 18, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | ME17550 | FL | |
| Surgery of the Hand (Plastic Surgery) Physician | 2082S0105X | ME17550 | FL | |
| Legal Medicine (M.D./D.O.) Physician | 209800000X | ME17550 | FL | Primary |
Addresses
Primary practice location
1501 SE 10TH St
Fort Lauderdale, FL 33316-1419
Mailing address
1501 SE 10TH St
Fort Lauderdale, FL 33316-1419
Phone (954) 523-7204
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME17550 | FL | MD | Legal Medicine (M.D./D.O.) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471478400000",
"number": "1861947996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 SE 10TH ST",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333161419",
"telephone_number": "954-523-7204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 SE 10TH ST",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333161419",
"telephone_number": "954-523-7204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALD",
"first_name": "HARLAN",
"middle_name": "IRA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-18",
"last_updated": "2016-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "FL",
"license": "ME17550",
"primary": false
},
{
"code": "2082S0105X",
"taxonomy_group": "",
"desc": "Plastic Surgery, Surgery of the Hand",
"state": "FL",
"license": "ME17550",
"primary": false
},
{
"code": "209800000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "FL",
"license": "ME17550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.