Wallingford, Walter Rudolph

Wallingford, Walter Rudolph is an sole proprietor health care provider with primary practice located at 2115 Executive Dr Suite 6C, Hampton VA 23666-2499. He recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as his primary health care specialty. Wallingford, Walter Rudolph can be contacted via phone (757) 874-7246.

Contact Information

Primary practice address
2115 Executive Dr Suite 6C Hampton VA 23666-2499
Phone: (757) 874-7246
Fax: (757) 826-9415
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 0101024223 Virginia

Profile Details

NPI number 1427132695
LBN Legal business name Wallingford, Walter Rudolph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2006
Last updated Aug 22nd, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427132695 NPPES
Virginia Other 15635 OPTIMA
Virginia Other 541005350 OPTIMA
Virginia Other 15635 OPTIMA
Virginia Other 002129 OPTIMA
Virginia MEDICAID 006045847 OPTIMA

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