Individual
DR. MATTHEW P WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2845 GREENBRIER ROAD, GREEN BAY, WI 54311
(920) 288-4746
(920) 288-4737
Mailing address
2845 GREENBRIER ROAD, GREEN BAY, WI 54311
(920) 288-4746
(920) 288-4737
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
104878
MN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
51649-20
WI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
53509
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
10/17/2006
Last updated
12/30/2021
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