Individual
KEVIN L WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4 DEERWOOD AVE NW, TRI-COUNTY HEALTH CARE WADENA CLINIC, WADENA, MN 56482-1296
(218) 631-1360
(218) 631-7507
Mailing address
415 JEFFERSON ST NORTH, TRI-COUNTY HOSPITAL, WADENA, MN 56482-1296
(218) 631-3510
(218) 631-7587
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37842
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0106020
MEDICA #
MN
01
—
0106027
MEDICA #
MN
01
—
0106028
MEDICA #
MN
01
—
13136
NDBS #
MN
01
—
142299
UCARE #
MN
01
—
21526
SIOUX VALLEY #
MN
01
—
768832
AMERICA'S PPO/ARAZ #
MN
05
—
890222400
—
MN
01
—
DA9041015691
PREFERRED ONE #
MN
01
—
HP19560
HEALTHPARTNERS #
MN
01
—
MN100008
LHS/BANNERHEALTH #
MN
Enumeration date
06/09/2006
Last updated
07/22/2015
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