Individual
DR. WALTER RUDOLPH WALLINGFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2115 EXECUTIVE DR, SUITE 6C, HAMPTON, VA 23666-2499
(757) 874-7246
(757) 826-9415
Mailing address
2115 EXECUTIVE DR, SUITE 6C, HAMPTON, VA 23666-2499
(757) 874-7246
(757) 826-9415
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
0101024223
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002129
ANTHEM BLUE CROSS & BLUE
VA
05
—
006045847
—
VA
01
—
15635
OPTIMA
VA
01
—
541005350
COMMERCIAL INSURANCE
—
Enumeration date
10/24/2006
Last updated
08/22/2008
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