Individual
DR. WALTER ALAN WYNKOOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 PLAZA DR, SUITE 2, TOMS RIVER, NJ 08757-3756
(732) 341-1380
(732) 505-9296
Mailing address
3 PLAZA DR, SUITE 2, TOMS RIVER, NJ 08757-3756
(732) 341-1380
(732) 505-9296
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
25MA07510000
NJ
207RP1001X
Pulmonary Disease Physician
Primary
25MA07510000
NJ
207RS0012X
Sleep Medicine (Internal Medicine) Physician
25MA07510000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009199
—
NJ
01
—
P00050076
RAILROAD MEDICARE
NJ
Enumeration date
03/15/2006
Last updated
12/22/2014
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