Individual
MARK R WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8020 CONSTITUTION PL NE STE 202, ALBUQUERQUE, NM 87110-7640
(505) 998-3096
(505) 998-3100
Mailing address
8020 CONSTITUTION PL NE STE 202, ALBUQUERQUE, NM 87110-7640
(505) 998-3096
(505) 998-3100
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
86-142
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01262716
—
CO
05
—
290049
—
AZ
05
—
P8B031463
—
TX
05
—
V5384
—
NM
Enumeration date
03/08/2007
Last updated
04/23/2025
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