Individual
WALTHER R EVENHUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
3330 NORTHSIDE DR STE 200, MACON, GA 31210-2574
(478) 309-1809
(478) 272-3589
Mailing address
3330 NORTHSIDE DR STE 200, MACON, GA 31210-2574
(478) 309-1809
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
111139
GA
207RC0000X
Cardiovascular Disease Physician
Primary
80066
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003346849B
—
GA
05
—
260221100
—
FL
Enumeration date
01/18/2007
Last updated
05/11/2026
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