MEDICARE: DAVID F WALLER MD

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	207Q00000X	Family Medicine Physician	0101047125	VA

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

General Provider Information

NPI Number	:	1518966688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID F WALLER MD

Provider Business Mailing Address
First Line	:	4868 BRIDGE RD
Second Line	:	SUITE 300
City	:	SUFFOLK
State	:	VA
Zip	:	23435-2048
Country	:	US
Telephone Number	:	757-483-7100
Fax Number	:	757-483-7150

Provider Business Practice Location Address
First Line	:	4868 BRIDGE RD
Second Line	:	SUITE 300
City	:	SUFFOLK
State	:	VA
Zip	:	23435-2048
Country	:	US
Telephone Number	:	757-483-7100
Fax Number	:	757-483-7150

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	07/22/2013

Similar Medicare Providers

1538979919 — KYLA JENKINS
Practice Location Address:

4868 BRIDGE RD STE 310
SUFFOLK, VA
23435-2048

Practice Phone: 757-483-7100
Practice Fax: 757-483-7150

1770583791 — MS. LAURA J MCGATH RN, CPNP
Practice Location Address:

4868 BRIDGE RD STE 310
SUFFOLK, VA
23435-2048

Practice Phone: 757-483-7113
Practice Fax: 757-483-7151

1013996222 — MISS APRIL CHANNING LUST P.A.
Practice Location Address:

4868 BRIDGE RD STE 300
SUFFOLK, VA
23435-2048

Practice Phone: 757-483-7100
Practice Fax: 615-320-3259

1174594352 — DR. LAURA SCHUETZ WRIGHT MD
Practice Location Address:

4868 BRIDGE RD
SUFFOLK, VA
23435-2048

Practice Phone: 757-483-7113
Practice Fax: 757-483-7151

1184687675 — DOUGLAS BLAIR GREGORY MD
Practice Location Address:

4868 BRIDGE ROAD
SUFFOLK, VA
23435-2048

Practice Phone: 757-483-7900
Practice Fax: 757-483-7151

1699731992 — PHILLIP RAY THOMASON MD
Practice Location Address:

4868 BRIDGE ROAD
SUFFOLK, VA
23435-2048

Practice Phone: 757-483-7900
Practice Fax: 757-483-7151

Directions to “ DAVID F WALLER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.