Provider Demographics
NPI:1871621342
Name:WALTOS, DAVID LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LAWRENCE
Last Name:WALTOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:28 ALLEGHENY AVE
Mailing Address - Street 2:SUITE 1208
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-3909
Mailing Address - Country:US
Mailing Address - Phone:410-583-5201
Mailing Address - Fax:410-583-5553
Practice Address - Street 1:28 ALLEGHENY AVE
Practice Address - Street 2:SUITE 1208
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-3909
Practice Address - Country:US
Practice Address - Phone:410-583-5201
Practice Address - Fax:410-583-5553
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD 00238012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry