Individual
DR. MARY ELLEN WALDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA09301700
NJ
208000000X
Pediatrics Physician
MD-043998-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016092820004
—
PA
05
—
0380491
—
NJ
Enumeration date
07/25/2006
Last updated
05/28/2014
Update your record
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