Individual provider · Type 1 NPI
Marilyn J. Waller-Niewold, D.P.M.
Foot & Ankle Surgery Podiatrist · Warm Springs, OR
NPI number
1568465177
Active
Practice location
1270 Kot-Num Road, Box 1209
Warm Springs, OR 98861
Fax (541) 553-2613
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | DP00352 (OR) |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | E3808 (CA) |
Foot & Ankle Surgery Podiatrist: Definition to come...
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Other foot & ankle surgery podiatrist providers in Warm Springs
About NPI 1568465177
Marilyn J. Waller-Niewold, D.P.M.'s National Provider Identifier is 1568465177, issued on May 27, 2005. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Warm Springs, OR. The record was last updated on Jun 14, 2011.