Individual
WALTER BEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18077 RIVER AVE, SUITE 104, NOBLESVILLE, IN 46062-8311
(317) 674-0208
(317) 674-0210
Mailing address
18077 RIVER AVE, SUITE 104, NOBLESVILLE, IN 46062-8311
(317) 674-0208
(317) 674-0210
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01025309
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100125340
—
IN
Enumeration date
10/23/2006
Last updated
10/21/2014
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