Individual
THOMAS WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2736
(320) 240-2203
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2736
(320) 240-2203
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
73124
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2020
Last updated
05/30/2023
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