Individual
MICHAEL C WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2817 NEW PINERY RD, PORTAGE, WI 53901-9240
(608) 745-5689
(608) 742-6098
Mailing address
2817 NEW PINERY ROAD, DIVINE SAVIOR HEALTHCARE, PORTAGE, WI 53901-0387
(608) 745-5689
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
43499
WI
Other
Enumeration date
03/30/2006
Last updated
10/12/2012
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