Provider Demographics
NPI:1518944727
Name:DALITSCH, WALTER WILLIAM III (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:WILLIAM
Last Name:DALITSCH
Suffix:III
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 817 BOX 32
Mailing Address - Street 2:
Mailing Address - City:FPO AE
Mailing Address - State:NAPLES
Mailing Address - Zip Code:09622
Mailing Address - Country:IT
Mailing Address - Phone:850-452-5140
Mailing Address - Fax:
Practice Address - Street 1:CAPODICHINO MEDICAL CLINIC
Practice Address - Street 2:PSC 817 BOX 32
Practice Address - City:FPO AE
Practice Address - State:NAPLES
Practice Address - Zip Code:09622
Practice Address - Country:IT
Practice Address - Phone:850-452-5140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK33572083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine