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Individual

STEVEN G WALTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
727 N LINCOLN RD, ROCKVILLE, IN 47872-1117
(765) 569-1123
(765) 569-6412
Mailing address
PO BOX 2505, INDIANAPOLIS, IN 46206-2505
(812) 238-7783
(812) 238-4506

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01034471
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100200590
IN
01
110020283
RR MEDICARE
IN
01
P00448381
RR MEDICARE
IN
Enumeration date
11/02/2005
Last updated
10/18/2010
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