Individual
JASON MICHAEL WALTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 BANNING ST, SUITE 250, DOVER, DE 19904
(302) 736-1320
(302) 736-0769
Mailing address
200 BANNING ST, SUITE 250, DOVER, DE 19904
(302) 736-1320
(302) 736-0769
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
CI0002871
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000059801
—
DE
Enumeration date
09/20/2005
Last updated
09/04/2008
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