Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MT199968 | PA |
Y | 208600000X | Surgeon | MT199968 | PA |
N | 2086S0120X | Pediatric Surgery | MD452138 | PA |
NPI | 1235425034 |
---|---|
Provider Name | Dr. Paul Kenneth Waltz II |
First Address | Pittsburgh, PA 15224-1334 |
Second Address | Pittsburgh, PA 15224-1334 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2011 |
Last Update Date | 16/04/2021 |