Individual
LONNY G WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 INTERNATIONAL DR., WILLIAMSVILLE, NY 14221
(716) 631-3555
(716) 631-9525
Mailing address
400 INTERNATIONAL DR., WILLIAMSVILLE, NY 14221
(716) 631-3555
(716) 631-9525
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
134833
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010185703
UNIVERA
NY
01
—
000508199005
BC/BS
NY
05
—
00753851
—
NY
01
—
0109758
IHA
NY
Enumeration date
01/18/2006
Last updated
02/18/2014
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