Individual
JAMES M WALDECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 MEDICAL CENTER DR STE 3500, HUNTINGTON, WV 25701-3655
(304) 691-1300
(304) 691-1375
Mailing address
1600 MEDICAL CENTER DR, SUITE 3500, HUNTINGTON, WV 25701-3656
(304) 691-1300
(304) 691-1375
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
14006
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112996000
—
WV
05
—
0752172
—
OH
05
—
64698301
—
KY
Enumeration date
04/17/2006
Last updated
12/30/2021
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