Individual
DR. WALTER E POFAHL II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
517 MOYE BLVD, GREENVILLE, NC 27834-2849
(252) 744-2393
(252) 744-1609
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
00613T
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265F
BCBS NC
NC
01
—
20047349
RAILROAD MEDICARE
NC
05
—
891265F
—
NC
Enumeration date
09/16/2005
Last updated
12/31/2021
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