Provider Demographics
NPI:1144212697
Name:HOWARD, WALTER WESLEY (M D)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:WESLEY
Last Name:HOWARD
Suffix:
Gender:M
Credentials:M D
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Other - Credentials:
Mailing Address - Street 1:2600 MILTON HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-8108
Mailing Address - Country:US
Mailing Address - Phone:434-971-7170
Mailing Address - Fax:434-971-7170
Practice Address - Street 1:200 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:LURAY
Practice Address - State:VA
Practice Address - Zip Code:22835-1000
Practice Address - Country:US
Practice Address - Phone:540-743-4561
Practice Address - Fax:540-743-1512
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101036519207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD85343Medicare UPIN