Individual
WALTER ELROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 W. PARK ST., EMERGENCY MED., URBANA, IL 61801-2500
(217) 383-3313
(217) 383-4014
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6941
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036140323
IL
207P00000X
Emergency Medicine Physician
35-07-5044
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000271432
ANTHEM
OH
01
—
000000372958
ANTHEM
OH
05
—
2095950
—
OH
01
—
341960760027
CARESOURCE
OH
05
—
4429887
—
MI
01
—
727137
BCHP
OH
05
—
810547599035
—
OH
Enumeration date
03/27/2006
Last updated
12/29/2017
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