Individual
DR. DAVID WALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
810 E SUNFLOWER RD, SUITE 100A, CLEVELAND, MS 38732-2800
(662) 843-3606
(662) 846-1194
Mailing address
810 E SUNFLOWER RD, SUITE 100A, CLEVELAND, MS 38732-2800
(662) 843-3606
(662) 846-1194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
09199
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115142
—
MS
01
—
P00232468
MEDICARE RAILROAD
MS
Enumeration date
03/17/2006
Last updated
12/11/2009
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