Individual
MAX WALDRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 FISHER ST, BILOXI, MS 39534-2508
(228) 376-0500
Mailing address
3919 HANSHAW RD, OCEAN SPRINGS, MS 39564-9458
(734) 883-1949
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
32420
MS
207P00000X
Emergency Medicine Physician
35.143907
OH
390200000X
Student in an Organized Health Care Education/Training Program
35.143907
OH
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
02/26/2020
Last updated
11/03/2023
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