Individual
PATRICK ROGER WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
904 5TH AVE NE, JAMESTOWN, ND 58401-3437
(701) 253-4020
(701) 253-4040
Mailing address
8171 31ST ST SE UNIT 6, JAMESTOWN, ND 58401-9258
(701) 252-7067
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71138
—
ND
Enumeration date
05/11/2010
Last updated
10/25/2012
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