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Individual

DR. WALTER H. EGENMAIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
101 NW 1ST ST, SUITE 112, EVANSVILLE, IN 47708-1259
(812) 426-2020
(812) 426-2828
Mailing address
101 NW 1ST ST, SUITE 112, EVANSVILLE, IN 47708-1259
(812) 426-2020
(812) 426-2828

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1000DT
KY
152W00000X
Optometrist
1235
GA
152W00000X
Optometrist
Primary
18002611
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100377200
IN
01
410021835
PALMENTO GBA
IN
01
4544563
AETNA
IN
05
77340404
KY
01
839180
MEDICARE
IN
01
87793
ANTHEM
IN
Enumeration date
06/01/2005
Last updated
09/03/2011
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