Individual
DR. WALTER HENRY HALLORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 ARCADE AVE STE 230, ELKHART, IN 46514-2485
(574) 522-6565
(574) 522-5572
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01039629
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100103250
—
IN
Enumeration date
11/22/2006
Last updated
03/30/2021
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