Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEROME H WALLER JR., M.D.
ActiveJEROME H WALLER JR., M.D. is a Family Medicine healthcare provider located in LIBERTY, South Carolina. NPI 1043262868 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · LIBERTY, SC
Registration Details
- NPI Number
- 1043262868
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 17, 2006 (20.098226256038 yrs)
- Last Updated
- Jun 30, 2021
- License
-
016611 (SC)
Practice Information
- Address
-
300 W FRONT STLIBERTY, SC, 296571012Browse SC providers · Browse ZIP 29657
- Phone
- 8648435605
- Fax
- 8648430996
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in LIBERTY, SC
| Name | Credential | NPI |
|---|---|---|
| DR. JOHN RANDOLPH | M.D. | 1689677882 |
| LORI R CARNSEW | MD | 1497713143 |
| MARK D WALSH | MD | 1265473813 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.