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Individual

WALTER DODARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
622 WASHINGTON ST, WATERTOWN, NY 13601-4036
(315) 788-2003
(315) 788-7087
Mailing address
PO BOX 91, WATERTOWN, NY 13601
(315) 782-4207
(315) 782-8699

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
226806
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02460786
NY
Enumeration date
05/23/2006
Last updated
03/31/2020
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