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General NPI Number Information
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NPI Number | 1982677332
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Entity Type | Individual
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Provider Name | SUZANNE JAFFE WALTERS M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 12/29/2021
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Provider Practice Location Address
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Address Line | 10215 FERNWOOD RD STE 506
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City | BETHESDA
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State | MD
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Zip | 20817-1184
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Country | US
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Telephone | 301-530-1010
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Fax | 301-897-8597
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Provider Business Mailing Address
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Address Line | 10215 FERNWOOD RD STE 506
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City | BETHESDA
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State | MD
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Zip | 20817-1184
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Country | US
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Telephone | 301-530-1010
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Fax | 301-897-8597
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | D68313
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | D0068313
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | ME100003
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 0101246103
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License Number State | VA
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