Healthcare Provider Details

I. General information

NPI: 1972552008
Provider Name (Legal Business Name): WALTER SIMEON JAMES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 01/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 COLLIER ROAD, NW SUITE 300
ATLANTA GA
30309-1740
US

IV. Provider business mailing address

275 COLLIER ROAD, NW SUITE 300
ATLANTA GA
30309-1740
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-2800
  • Fax: 404-351-5983
Mailing address:
  • Phone: 404-605-2800
  • Fax: 404-351-5983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number031948
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number031948
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: