Individual
WALTER R BOISVERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
610 E TAYLOR ST, PRAIRIE DU CHIEN, WI 53821-2109
(608) 326-6466
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27563
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31419400
—
WI
Enumeration date
06/09/2005
Last updated
09/21/2015
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