Individual
MR. WALTER DAVID SELVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1190 S SAINT FRANCIS DR, SANTA FE, NM 87505-4173
(505) 827-0006
Mailing address
2720 CALLE CEDRO, SANTA FE, NM 87505-5297
(505) 660-4282
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
94-PA05
NM
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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