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Individual
WALTER THAD RATHKAMP
Active
Individual
WALTER THAD RATHKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301068143
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4527494
—
MI
01
—
P00110021
RR MEDICARE
MI
Enumeration date
12/02/2005
Last updated
10/11/2018
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