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Individual

DR. WALTER LEE FAGGETT II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4013 16TH ST NW, NA, WASHINGTON, DC 20011-7001
(202) 723-3100
(202) 442-4790
Mailing address
4013 16TH ST NW, NA, WASHINGTON, DC 20011-7001
(202) 723-3100
(202) 442-4790

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
5270
DC
2080A0000X
Pediatric Adolescent Medicine Physician
5270
DC

Other

Enumeration date
11/02/2007
Last updated
03/18/2010
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