Individual
DR. STEWART LANE WALTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 UNIVERSITY OF NEW MEXICO, MSC10-5550, ALBUQUERQUE, NM 87131-0001
(505) 272-4253
(505) 272-4356
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD2017-0897
NM
207RC0000X
Cardiovascular Disease Physician
Primary
MD2017-0897
NM
390200000X
Student in an Organized Health Care Education/Training Program
RS2011-0333
NM
Other
Enumeration date
04/13/2011
Last updated
03/20/2018
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