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Contact Information

BENJAMIN R WALLER III, MD
51 N DUNLAP ST FL 2
MEMPHIS, TN38105
 Phone: 901-287-7337
 Fax: 901-287-4646
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Cardiology

207RI0011X 11 Physician/Internal Medicine
 

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for BENJAMIN R WALLER III · (Male)

NPI Number 1013974062
Status Active
Credentials MD
Entity Individual
Enumeration date 04/26/2006
Last updated 07/13/2018 - More than a year ago
Sole proprietor 1 No
Identifiers
  • TN License # 19846
  • TN Medicaid 3086106
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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