Individual
DR. WALTER ALFRED DIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4109 JOHN ALDEN LN, LEXINGTON, KY 40504-2043
(859) 281-4902
Mailing address
4109 JOHN ALDEN LN, LEXINGTON, KY 40504-2043
(859) 281-4902
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
0101054852
VA
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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