Provider Demographics
NPI:1861705444
Name:SHAKESPEARE, WALTER GREGORY (DO)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:GREGORY
Last Name:SHAKESPEARE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:4769 MEADOWVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-9013
Mailing Address - Country:US
Mailing Address - Phone:610-390-7668
Mailing Address - Fax:
Practice Address - Street 1:230 N BROAD ST
Practice Address - Street 2:HAHNEMAN UNIVERSITY HOSPITAL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1121
Practice Address - Country:US
Practice Address - Phone:610-390-7668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT013798207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine