DOUGLAS GEORGE WALLED (NPI# 1235377334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235377334 |
| Entity Type | Individual |
| Full Name | DOUGLAS GEORGE WALLED |
| Credential | M.D. |
| Practice Address |
315 So Manning Blvd Sph Medical Imaging Albany NY 12208 |
| Mailing Address |
425 New Scotland Avenue Sphpma Credentialing Albany NY 12208 |
| Practice Telephone | 5185251550 |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2019-04-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
265496 | NY | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
049745 | CT | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Edgewater St, 6th Floor Suite 3 Attn Teresa Lomangino, Staten Island, NY 103054907 | 7189477000 | 7189477005 |
| Street Address |
315 SO MANNING BLVD SPH MEDICAL IMAGING |
| City | ALBANY |
| State | NY |
| Zip Code | 12208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669099750 | Stephanie Kathleen Dulay | Nurse Practitioner | 315 So Manning Blvd, Sparc, Albany, NY 12208-1707 | 2020-07-06 |
| 1922623586 | Samantha Marion Hutchins | Physician Assistant | 315 So Manning Blvd, Hospitalist Department, Albany, NY 12208-1707 | 2020-06-10 |
| 1225652118 | Sarah Jeannette Klepp | Physician Assistant | 315 So Manning Blvd, St. Peter's Hospital, Albany, NY 12208-1707 | 2020-06-05 |
| 1821611062 | Emma R Cummings | Physician Assistant | 315 So Manning Blvd, Hospitalist Department, Albany, NY 12208-1707 | 2020-05-22 |
| 1801440185 | Jessica Hoffman | Physician Assistant | 315 So Manning Blvd, St. Peter's Hospital, Albany, NY 12208 | 2019-07-25 |
| 1144742875 | Isha N Vyas | Physician Assistant | 315 So Manning Blvd, St. Peter's Hospital of The City of Albany, Albany, NY 12208 | 2017-07-14 |
| 1760932040 | Emily Marissa Reynolds | Physician Assistant | 315 So Manning Blvd, Surgical Pa Room 7422, Albany, NY 12208 | 2016-10-10 |
| 1619330396 | Ashok A Ramani | Hospitalist | 315 So Manning Blvd, St. Peter's Hospital Department, Albany, NY 12208 | 2016-03-31 |
| 1093145658 | Dan Liu | Internal Medicine | 315 So Manning Blvd, Hospitalist Dept, Albany, NY 12208 | 2013-11-19 |
| 1811281587 | Chrystal Debra Price | Internal Medicine | 315 So Manning Blvd, Hospitalist Department, Albany, NY 12208 | 2011-05-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255959045 | Fatima Mahmood | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Department of Internal Medicine, Albany, NY 12208 | 2020-07-08 |
| 1861021784 | Jessica Anne Charles-larose | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Family Medicine, Albany, NY 12208 | 2020-04-02 |
| 1235767211 | Michael Charles Harrington | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Orthopedic Surgery, Albany, NY 12208 | 2020-03-27 |
| 1518594126 | Arkar Htoo | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of Pathology, Albany, NY 12208 | 2020-03-24 |
| 1366079030 | Omar Merdan | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Dept of Medicine/pediatrics, Albany, NY 12208 | 2020-03-24 |
| 1306473079 | Sergo Gabunia | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of General Surgery, Albany, NY 12208 | 2020-03-24 |
| 1205469392 | Cornell Andre Morris | Social Worker | Albany Stratton Va Medical Center, 113 Holland Avenue, Albany, NY 12208 | 2020-02-17 |
| 1558909234 | St. Peter's Health Partners Medical Associates, P.C. | Surgery | 319 South Manning Blvd Suite 310, Capital Region Colon & Rectal Surgery, Albany, NY 12208 | 2019-12-13 |
| 1912543265 | Meghan Rose Baxter | Social Worker | 58 Academy Rd., Albany, NY 12208 | 2019-11-21 |
| 1245883461 | Gwendolyn Medak | Registered Nurse | 15 New Scotland Ave, Albany, NY 12208 | 2019-07-17 |
| Find all providers in zip 12208 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962846956 | Anthony Edward Lang | Radiology | 17 Colonial Ave, Albany, NY 12203-2009 | 2013-04-22 |
| 1073881157 | Frank Maynard Thames Jr. | Radiology | 2219 Golf Course Dr, Albany, GA 31721-2079 | 2011-12-05 |
| 1487934188 | Maurice Emile Marchand | Radiology | 43 New Scotland Ave, Dept of Radiology, Albany Medical Center Hospital, Albany, NY 12208 | 2011-08-25 |
| 1285926709 | Marco Diego Vitto | Radiology | 47 New Scotland Ave Dept Of, Albany, NY 12208-3412 | 2011-05-03 |
| 1629368519 | Joseph M Rozell | Radiology | 255 Patroon Creek Blvd Apt 3439, Albany, NY 12206 | 2011-04-12 |
| 1922203413 | John Ronald Andrews | Radiology | 2205 West Doublegate Drive, Albany, GA 31721 | 2007-06-15 |
| 1942402110 | Michael Brooks Whiteside | Radiology | 1365 Washington Ave Ste 103, Albany, NY 12206-1098 | 2007-06-01 |
| 1255415063 | Gary Siskin | Radiology | Albany Medical Center Hospital, 47 New Scotland Ave - Radiology, Albany, NY 12208 | 2006-10-25 |
| 1639268956 | Royce Marlin Cannington IIi | Radiology | 2715 Mccall Ct, Albany, GA 31721-9194 | 2006-10-12 |
| 1104929264 | Raul L. Diokno | Radiology | Stratton Va Medical Center 113 Holland Ave., Albany, NY 12208 | 2006-09-06 |
| Find all providers in ALBANY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.