Provider Demographics
NPI:1982696522
Name:CAULFIELD, WALTER HARRY III (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:HARRY
Last Name:CAULFIELD
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:2391 COURT DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2196
Mailing Address - Country:US
Mailing Address - Phone:704-874-0095
Mailing Address - Fax:704-866-8680
Practice Address - Street 1:2391 COURT DR
Practice Address - Street 2:SUITE 120
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2196
Practice Address - Country:US
Practice Address - Phone:704-874-0095
Practice Address - Fax:704-866-8680
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2010-02-15
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Provider Licenses
StateLicense IDTaxonomies
NC96003992086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F58498Medicare UPIN