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Individual

LAWRENCE M WALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1648 HUNTINGDON PIKE, ATTN: RADIOLOGY, MEADOWBROOK, PA 19046-8001
(215) 612-2610
(215) 612-5077
Mailing address
PO BOX 782743, ATTN: CREDENTIALING, PHILADELPHIA, PA 19178-2743
(602) 910-6887
(215) 612-5077

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25MA08175600
NJ
2085R0202X
Diagnostic Radiology Physician
Primary
MD028654E
PA

Other

Enumeration date
01/25/2006
Last updated
01/20/2016
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