Individual
RICHARD WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1813 WILLOW ST, SUITE 5 B, VINCENNES, IN 47591-4267
(812) 882-2703
(812) 882-2760
Mailing address
1813 WILLOW ST, SUITE 5 B, VINCENNES, IN 47591-4267
(812) 882-2703
(812) 882-2760
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
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