MEDICARE: HORACE E WALPOLE JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	20112	SC
2	207R00000X	Internal Medicine Physician	20112	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8558	OTHER	SC	REGENCY HOSPITAL

General Provider Information

NPI Number	:	1255307898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HORACE E WALPOLE JR. MD

Provider Business Mailing Address
First Line	:	PO BOX 51158
Second Line	:
City	:	PIEDMONT
State	:	SC
Zip	:	29673-2158
Country	:	US
Telephone Number	:	864-220-0103
Fax Number	:	864-220-9925

Provider Business Practice Location Address
First Line	:	100 POWERS BLVD.
Second Line	:
City	:	PIEDMONT
State	:	SC
Zip	:	29673-2158
Country	:	US
Telephone Number	:	864-220-0103
Fax Number	:	864-220-9925

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	07/11/2024

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Directions to “ HORACE E WALPOLE JR. MD” Practice Location

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