Provider Demographics
NPI:1770730699
Name:CURRY, WALTER JR
Entity type:Individual
Prefix:MR
First Name:WALTER
Middle Name:
Last Name:CURRY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 S BELTLINE BLVD APT F15
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-4269
Mailing Address - Country:US
Mailing Address - Phone:803-404-9088
Mailing Address - Fax:
Practice Address - Street 1:504 S BELTLINE BLVD APT F15
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-4269
Practice Address - Country:US
Practice Address - Phone:803-404-9088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC423254171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor