Provider Demographics
NPI:1376651844
Name:SALL, WALTER FRIEDRICH (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:FRIEDRICH
Last Name:SALL
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:81 HIGHLAND AVE
Mailing Address - Street 2:NORTH SHORE HEALTH SYSTEMS
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970
Mailing Address - Country:US
Mailing Address - Phone:978-354-4173
Mailing Address - Fax:
Practice Address - Street 1:17 CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960
Practice Address - Country:US
Practice Address - Phone:978-977-9400
Practice Address - Fax:978-538-0341
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2013-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2204002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology