Individual
DR. MICHAEL JAMES WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-0109
(352) 265-0761
Mailing address
PO BOX 100109, GAINESVILLE, FL 32610-0109
(352) 265-0761
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ME 100881
FL
208600000X
Surgery Physician
Primary
ME100881
FL
390200000X
Student in an Organized Health Care Education/Training Program
ME100881
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009642400
—
FL
01
—
1487752796
NPI
FL
01
—
AK347W
MEDICARE
FL
01
—
ME 100881
MEDICAL LICENSE
FL
Enumeration date
09/20/2006
Last updated
07/21/2022
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