Individual
MR. GARY DAVID WALDMAN
Active
Individual
MR. GARY DAVID WALDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
26610
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070009176
RAILROAD MEDICARE
NC
05
—
7985246
—
NC
01
—
85246
BLUE CROSS BLUE SHIELD
NC
Enumeration date
03/29/2006
Last updated
04/03/2012
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