Individual
DR. MICHAEL ANDREW WALBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
404 E ASH ST, PERRY, FL 32347-2105
(850) 584-2200
(888) 429-8421
Mailing address
404 E ASH ST, PERRY, FL 32347-2105
(850) 584-2200
(888) 429-8421
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP1063
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084889100
—
FL
01
—
19142
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/22/2006
Last updated
11/10/2010
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