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Individual

KENNETH CHET WALTERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2000 E GREENVILLE ST STE 1100, ANDERSON, SC 29621-1714
(864) 512-5667
(864) 512-6746
Mailing address
PO BOX 100174, COLUMBIA, SC 29202-3174
(864) 512-5667
(864) 512-6746

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
34958
SC
390200000X
Student in an Organized Health Care Education/Training Program
11014996A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003166327A
GA
05
349581
SC
Enumeration date
06/16/2009
Last updated
01/05/2023
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