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Individual
MR. WALTER DOUGLAS KOLMODIN
Active
Individual
MR. WALTER DOUGLAS KOLMODIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000902A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000262667
BLUE CROSS BLUE SHIELD
IN
Enumeration date
09/13/2005
Last updated
07/10/2024
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