Individual
GRACE WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4414 BENNING RD NE, WASHINGTON, DC 20019-4555
(202) 469-4699
Mailing address
4151 BLADENSBURG RD, COLMAR MANOR, MD 20722-1928
(301) 699-7700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD210002182
DC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2019
Last updated
08/12/2022
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