Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Matthew Lucas Wall

Individual provider Pediatric Nurse Practitioner · NPI 1821746777

Matthew Lucas Wall is a Pediatric Nurse Practitioner in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2022.

Licensed in
PA
In the registry since
2022

Practice location Address checks out

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone: (215) 590-1000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence SP025443 (PA)

Record details

NPI number1821746777
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 10, 2022
Last updated in NPPESMarch 10, 2022
Certification dateMarch 10, 2022

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