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Individual

WALTER M RICHTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3 UPPER MILLER HILL RD, PROVINCETOWN, MA 02657-1628
(508) 487-2303
Mailing address
PO BOX 262, PROVINCETOWN, MA 02657-0262
(508) 487-2303

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
44126
MA
208D00000X
General Practice Physician
Primary
10823
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2073986
MA
01
L11013
BLUE SHIELD
MA
Enumeration date
06/05/2006
Last updated
06/08/2021
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