Individual
DR. WALTER LEE IRVING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1925 BRETON RD SE, GRAND RAPIDS, MI 49506-4810
(616) 252-4100
(616) 252-4953
Mailing address
1925 BRETON RD SE, GRAND RAPIDS, MI 49506-4810
(616) 252-4100
(616) 252-4953
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
5101006557
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3054284
—
MI
01
—
5101006557
STATE LICENSE NUMBER
MI
Enumeration date
07/19/2006
Last updated
06/16/2010
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