Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RICHARD EDWIN WALLER, M.D.
ActiveRICHARD EDWIN WALLER, M.D. is a Family Medicine healthcare provider located in MARKS, Mississippi. NPI 1821001041 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · MARKS, MS
Registration Details
- NPI Number
- 1821001041
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 15, 2006 (19.993485681653 yrs)
- Last Updated
- Mar 1, 2017
- License
-
07067 (MS)
Practice Information
- Address
-
1024 MARTIN LUTHER KING DRIVEMARKS, MS, 386460289Browse MS providers · Browse ZIP 38646
- Phone
- 6623263502
- Fax
- 6623262555
- Primary Specialty
-
Family Medicine
207Q00000X
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.