Provider Demographics
NPI:1093966897
Name:WALTERS, JAMIE BETH (MD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:BETH
Last Name:WALTERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:BETH
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7505 OSLER DR
Mailing Address - Street 2:SUITE 502
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7736
Mailing Address - Country:US
Mailing Address - Phone:410-296-4210
Mailing Address - Fax:410-296-4213
Practice Address - Street 1:7505 OSLER DR
Practice Address - Street 2:SUITE 502
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7736
Practice Address - Country:US
Practice Address - Phone:410-296-4210
Practice Address - Fax:410-296-1489
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD75610207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology