Individual
DR. JOSEPH A VANDER WALDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6104 OLD BRANCH AVE, TEMPLE HILLS, MD 20748-2518
(301) 702-5100
(301) 702-6366
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
(301) 816-6308
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101029782
VA
208000000X
Pediatrics Physician
Primary
D0022101
MD
208000000X
Pediatrics Physician
MD11026
DC
Other
Enumeration date
12/12/2006
Last updated
05/27/2021
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