Individual
ROBERT C WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
446 MORGAN ST, CINCINNATI, OH 45206-2348
(833) 510-4357
Mailing address
4600 MONTGOMERY RD STE 400, CINCINNATI, OH 45212-2600
(513) 873-1269
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301087247
MI
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
4301087247
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00343656
RAILROAD MEDICARE
MI
Enumeration date
05/10/2006
Last updated
11/14/2024
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