Individual
EVA JAYNE WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7320
Mailing address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2016-01079
NC
207LP3000X
Pediatric Anesthesiology Physician
Primary
0101278464
VA
Other
Enumeration date
06/06/2011
Last updated
11/03/2024
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