Individual
DR. WALTER JAMES DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
853 N CHURCH ST, SUITE 620, SPARTANBURG, SC 29303-3098
(864) 560-1674
(864) 560-1690
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
7751
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
077561
—
SC
01
—
23151
MEDCOST
SC
01
—
4226842
AETNA
SC
05
—
890545G
—
NC
Enumeration date
01/30/2006
Last updated
12/23/2020
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