Individual
DOUGLAS WALLED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 SO MANNING BLVD, SPH MEDICAL IMAGING, ALBANY, NY 12208
(518) 525-1550
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
049745
CT
2085R0202X
Diagnostic Radiology Physician
Primary
265496
NY
Other
Enumeration date
01/27/2009
Last updated
05/27/2021
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