Individual
DR. BRUCE WALDHOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
113 GAINSBOROUGH SQ STE 202, CHESAPEAKE, VA 23320-1714
(757) 436-3285
(757) 436-2262
Mailing address
113 GAINSBOROUGH SQ STE 101, CHESAPEAKE, VA 23320-1713
(757) 436-3285
(757) 432-2262
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0101042167
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15925
SENTARA
—
01
—
325201
ANTHEM
—
01
—
325204
ANTHEM
—
05
—
5821088
—
VA
01
—
P00022692
RAILROAD MEDICARE
—
Enumeration date
07/20/2005
Last updated
05/29/2019
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