Individual
WALTER E PAE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 233-4082
Mailing address
PO BOX 854, MC A410, HERSHEY, PA 17033-0854
(800) 233-4082
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD021710E
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD021710E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008075510001
—
PA
Enumeration date
05/03/2006
Last updated
03/17/2018
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