Individual
DAVID MICHAEL WALBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
893 COLVIN BLVD, KENMORE, NY 14217-2423
(716) 873-4406
(716) 873-4420
Mailing address
893 COLVIN BLVD, KENMORE, NY 14217-2423
(716) 873-4406
(716) 873-4420
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
183082
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010185504
UNIVERA
—
01
—
000511107004
BLUE CROSS
NY
05
—
01257914
—
NY
01
—
071227000043
FIDELIS
—
01
—
1703730
IHA
—
Enumeration date
09/01/2006
Last updated
09/22/2022
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