Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 53277 | CT |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 53277 | CT |
NPI | 1164763306 |
---|---|
Provider Name | Dr. Raymond John Walls |
First Address | New Haven, CT 06519-1369 |
Second Address | New York, NY 10016-6402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2013 |
Last Update Date | 28/04/2021 |