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Individual
CORNELIUS TODD WALTER
Active
Individual
CORNELIUS TODD WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17420
SC
207Q00000X
Family Medicine Physician
9601513
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080120336
RAIL ROAD MEDICARE
SC
05
—
174206
—
SC
01
—
2279674C
MEDICARE PIN
NC
01
—
5850260
AETNA
SC
01
—
66392
MEDCOST
SC
05
—
890665G
—
NC
01
—
F876975121
MEDICARE PIN
SC
01
—
P00721817
RR MEDICARE
NC
Enumeration date
01/31/2006
Last updated
01/13/2021
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