Individual
RICHARD WALTER
Active
Individual
RICHARD WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
02000873
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000847454
ANTHEM
IN
05
—
100427420
—
IN
Enumeration date
07/26/2005
Last updated
09/29/2016
Update your record
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