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Individual
WALTER G WARREN
Active
Individual
WALTER G WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000678
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000092305
BCBS
IN
05
—
100140790A
—
IN
01
—
380042P
SIHO
IN
01
—
480024209
PALMETTO GBA RAILROAD
IN
01
—
508770008
MEDICARE 2016
—
Enumeration date
08/19/2006
Last updated
03/06/2020
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