Provider Demographics
NPI:1558365593
Name:PEPPELMAN, WALTER C (DO)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:C
Last Name:PEPPELMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3399 TRINDLE RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4407
Mailing Address - Country:US
Mailing Address - Phone:717-761-5530
Mailing Address - Fax:717-737-7197
Practice Address - Street 1:820 SIR THOMAS CT
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4839
Practice Address - Country:US
Practice Address - Phone:717-652-9555
Practice Address - Fax:717-657-9023
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005888L207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010532880008Medicaid
PA1053288Medicaid
PAPE482882Medicare ID - Type Unspecified