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Individual

DR. JOSEPH G WALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., M.P.H.

Contact information

Practice address
1475 KISKER RD STE 180, SAINT CHARLES, MO 63304-8786
(636) 442-7300
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-2551

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
04-37203
KS
2085R0001X
Radiation Oncology Physician
079384
GA
2085R0001X
Radiation Oncology Physician
Primary
2014013923
MO

Other

Enumeration date
05/21/2009
Last updated
10/27/2020
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