Individual
HALEY N WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2701 N DECATUR RD, PATHOLOGY DEPARTMENT, DECATUR, GA 30033
(847) 767-9012
Mailing address
3100 W PAUL AVE UNIT 8, TAMPA, FL 33611-3772
(601) 433-0519
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
2891
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2981
ASCP PA
—
Enumeration date
05/26/2022
Last updated
05/26/2022
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