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General NPI Number Information
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NPI Number | 1114142254
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Entity Type | Individual
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Provider Name | KAREN MARIE WALTZ MD
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Gender | Female
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 1934 SECURITY DRIVE
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City | YORK
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State | PA
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Zip | 17402
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Country | US
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Telephone | 717-741-3761
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Fax | 717-741-9495
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Provider Business Mailing Address
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Address Line | 69 BROOKVIEW DRIVE
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City | LITITZ
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State | PA
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Zip | 17543
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Country | US
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Telephone | 717-741-3761
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD061740L
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License Number State | PA
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