Individual
DUSTY WALTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
10122 E 10TH ST STE 210, INDIANAPOLIS, IN 46229-2664
(317) 355-7356
(317) 806-1175
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7468
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07001500A
IN
390200000X
Student in an Organized Health Care Education/Training Program
41000455A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300063548
—
IN
Enumeration date
04/12/2022
Last updated
06/23/2025
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