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NPI Code Detail

MEDICARE: WALTER GAJEWSKI MD

MEDICARE: WALTER GAJEWSKI 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
1207VX0201XGynecologic Oncology Physician200400032NC

General Provider Information

NPI Number : 1689679052
Entity Type Code : Individual
Provider Name (Legal Business Name) : WALTER GAJEWSKI MD
Provider Business Mailing Address
First Line : PO BOX 936857
Second Line :
City : ATLANTA
State : GA
Zip : 31193-6857
Country : US
Telephone Number : 910-667-3000
Fax Number : 910-667-6758
Provider Business Practice Location Address
First Line : 2131 S 17TH ST
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7407
Country : US
Telephone Number : 910-667-3000
Fax Number : 910-667-6758
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 05/27/2021

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