Individual
KENNETH CHRISTIAN WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 667-7000
(910) 662-8909
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 667-7000
(910) 662-8909
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
069664
GA
208600000X
Surgery Physician
Primary
2024-01721
NC
208600000X
Surgery Physician
E-7272
AR
2086S0120X
Pediatric Surgery Physician
069664
GA
2086S0120X
Pediatric Surgery Physician
2024-01721
NC
2086S0120X
Pediatric Surgery Physician
E-7272
AR
Other
Enumeration date
03/02/2007
Last updated
10/15/2024
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