Healthcare Provider Details

I. General information

NPI: 1396744587
Provider Name (Legal Business Name): WALTER L GEORGE JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 02/08/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4141 ROCKSIDE RD STE 210
SEVEN HILLS OH
44131-2537
US

IV. Provider business mailing address

665 S SUSSEX CT
AURORA OH
44202-7693
US

V. Phone/Fax

Practice location:
  • Phone: 216-298-1995
  • Fax: 216-502-3696
Mailing address:
  • Phone: 330-842-1060
  • Fax: 330-562-4038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35043159
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: