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Individual

MR. STEVEN J WALTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
4370 W MAIN ST, DOTHAN, AL 36305-1056
(334) 793-5000
Mailing address
4005 PEBBLECREEK LN, DOTHAN, AL 36303-1439
(334) 699-5535

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA680
AL
363A00000X
Physician Assistant
Primary
PA9102944
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
292271100
FL
Enumeration date
10/17/2005
Last updated
09/11/2012
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