Provider Demographics
NPI:1396744587
Name:GEORGE, WALTER L JR (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:L
Last Name:GEORGE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:665 S SUSSEX CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-7693
Mailing Address - Country:US
Mailing Address - Phone:330-842-1060
Mailing Address - Fax:330-562-4038
Practice Address - Street 1:4141 ROCKSIDE RD STE 210
Practice Address - Street 2:
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-2537
Practice Address - Country:US
Practice Address - Phone:216-298-1995
Practice Address - Fax:216-502-3696
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2025-02-08
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Provider Licenses
StateLicense IDTaxonomies
OH350431592085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E59475Medicare UPIN