Individual
KEITH ANDREW WALTER
Active
Individual
KEITH ANDREW WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
9600766
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15401
PARTNERS
—
01
—
180044444
RR MEDICARE
—
05
—
3002831000
—
WV
01
—
5515617
AETNA
—
05
—
6304443
—
VA
01
—
65769
MEDCOST
—
01
—
8552T
BCBS
—
05
—
898552T
—
NC
Enumeration date
11/28/2005
Last updated
08/23/2010
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