Individual
WALTER J CHWALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-5000
Mailing address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-5000
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
35-080813
OH
2086S0120X
Pediatric Surgery Physician
Primary
54706
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000204731
UNISON
OH
01
—
000000503637
ANTHEM
—
01
—
1012234150001
PENNSYLVANIA MEDICAID
PA
01
—
2319539
BCMH
OH
05
—
2319539
—
OH
01
—
363426
WELLCARE
OH
01
—
3810009981
WEST VIRGINIA MEDICAID
WV
01
—
5904683
AETNA
—
01
—
734678
BUCKEYE
OH
Enumeration date
07/14/2006
Last updated
01/29/2014
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