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Contact Information

CEDRIC R WALLER
171 ASHMOUNT DR
KANNAPOLIS, NC28081
 Phone: 901-491-5007
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nutrition, Education

133NN1002X
Indicates primary specialty

NPI Profile & details for CEDRIC R WALLER · (Male)

NPI # 1639824907
Status Active
Credentials
Entity Individual
Enumeration date 02/15/2022
Last updated 02/15/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers Not Available
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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