Provider Demographics
NPI:1902369069
Name:CYPHERS, WALTER F (DO)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:F
Last Name:CYPHERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11810 HUNTERS RIDGE BLVD APT 4
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-6272
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:202 COVE FORGE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:PA
Practice Address - Zip Code:16693-7138
Practice Address - Country:US
Practice Address - Phone:814-317-0339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-07
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAOS020762207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program