Basic Information
| Provider Information | |||||||||
| NPI: | 1982696522 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAULFIELD | ||||||||
| FirstName: | WALTER | ||||||||
| MiddleName: | HARRY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2391 COURT DR | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280542196 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048740095 | ||||||||
| FaxNumber: | 7048668680 | ||||||||
| Practice Location | |||||||||
| Address1: | 2391 COURT DR | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280542196 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048740095 | ||||||||
| FaxNumber: | 7048668680 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2005 | ||||||||
| LastUpdateDate: | 02/15/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0122X | 9600399 | NC | Y | Allopathic & Osteopathic Physicians | Surgery | Plastic and Reconstructive Surgery |
No ID Information.