Waldheim, Eddie Clark

Waldheim, Eddie Clark is an individual health care provider with primary practice located at 402 Lake Howell Rd , Maitland FL 32751-5907. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Waldheim, Eddie Clark can be contacted via phone (407) 628-4312.

Contact Information

Primary practice address
402 Lake Howell Rd Maitland FL 32751-5907
Phone: (407) 628-4312
Fax: (407) 628-1845
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME46344 Florida

Profile Details

NPI number 1881797082
LBN Legal business name Waldheim, Eddie Clark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2006
Last updated Apr 22nd, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881797082 NPPES
Florida MEDICAID 370808000

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