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NPI 1306817507

NPI 1306817507 : WALTER HUDSON MAJAK DPM : WATERTOWN, NY

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General NPI Number Information
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    NPI Number           |    1306817507
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    Entity Type          |    Individual 
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    Provider Name        |    WALTER HUDSON MAJAK DPM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/27/2006
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    Last Update Date     |    12/19/2012
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Provider Practice Location Address
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    Address Line         |    513 WASHINGTON ST SUITE 2
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    City                 |    WATERTOWN
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    State                |    NY
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    Zip                  |    13601-4001
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    Country              |    US
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    Telephone            |    315-782-4800
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    Fax                  |    315-788-6835
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Provider Business Mailing Address
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    Address Line         |    513 WASHINGTON ST 
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    City                 |    WATERTOWN
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    State                |    NY
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    Zip                  |    13601-4001
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    Country              |    US
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    Telephone            |    315-782-4800
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    Fax                  |    315-788-6835
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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        |    213E00000X
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    Taxonomy Name        |    Podiatrist
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    License Number       |    N0034861
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    License Number State |    NY
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