Waller, Benjamin R

Waller, Benjamin R is an individual health care provider with primary practice located at 51 N Dunlap St Fl 2 , Memphis TN 38105. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Cardiology, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Waller, Benjamin R can be contacted via phone (901) 287-7337.

Contact Information

Primary practice address
51 N Dunlap St Fl 2 Memphis TN 38105
Phone: (901) 287-7337
Fax: (901) 287-4646
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 19846 Tennessee
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 19846 Tennessee

Profile Details

NPI number 1013974062
LBN Legal business name Waller, Benjamin R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jul 13th, 2018 - about 8 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 1013974062 NPPES
Tennessee MEDICAID 3086106

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