Individual
KENNETH MICHAEL WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
72 S WASHINGTON ST, SUITE 102, OXFORD, MI 48371-6421
(248) 236-8333
(248) 236-8666
Mailing address
72 S WASHINGTON ST, SUITE 102, OXFORD, MI 48371-6421
(248) 236-8333
(248) 236-8666
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704230530
MI
363LF0000X
Family Nurse Practitioner
Primary
4704230530
MI
Other
Enumeration date
02/09/2011
Last updated
09/10/2012
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