Individual
DR. BRENT MICHAEL WALZ
Active
Individual
DR. BRENT MICHAEL WALZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01060263A
IN
207X00000X
Orthopaedic Surgery Physician
39291
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000365692
IN BC
IN
01
—
1720078900
NPI
IN
05
—
200354700A
—
IN
05
—
7100620820
—
KY
01
—
IN2570009
MEDICARE
IN
Enumeration date
10/27/2005
Last updated
04/02/2024
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