Provider Demographics
NPI:1639101553
Name:BLAND, WALTER (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:
Last Name:BLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2041 GEORGIA AVE NW
Mailing Address - Street 2:STE 6101
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20060-0001
Mailing Address - Country:US
Mailing Address - Phone:202-595-3223
Mailing Address - Fax:202-332-2985
Practice Address - Street 1:530 COLLEGE ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20059-0001
Practice Address - Country:US
Practice Address - Phone:202-806-7981
Practice Address - Fax:202-806-4083
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2017-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCMD131422084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC029966300Medicaid
MD133504900Medicaid
MD133504900Medicaid
B94486Medicare UPIN