MEDICARE: STEPHANIE G WALTER DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	OS014105	PA
2	208000000X	Pediatrics Physician	C20008477	DE
3	208D00000X	General Practice Physician	OS014105	PA
4	208000000X	Pediatrics Physician	OS014105	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013032770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE G WALTER DO

Provider Business Mailing Address
First Line	:	1403 FOULK RD STE 103
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19803-2788
Country	:	US
Telephone Number	:	302-762-6222
Fax Number	:	302-764-6058

Provider Business Practice Location Address
First Line	:	1403 FOULK RD STE 103
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19803-2788
Country	:	US
Telephone Number	:	302-762-6222
Fax Number	:	302-764-6058

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	10/24/2024

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Directions to “ STEPHANIE G WALTER DO” Practice Location

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