Individual
DR. WALTER W VIRKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 N SENATE BLVD, STE 535, INDIANAPOLIS, IN 46202-1204
(317) 963-1950
(317) 963-1955
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01071856A
IN
207X00000X
Orthopaedic Surgery Physician
036102954
IL
207XX0801X
Orthopaedic Trauma Physician
Primary
01071856A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036102954 2
—
IL
01
—
1633878
BCBS GROUP ID#
IL
05
—
201127550
—
IN
01
—
207067
MEDICARE PTAN LOCALITY 16
IL
01
—
207073
MEDICARE PTAN LOCALITY 15
IL
01
—
7736149
AETNA ID#
IL
01
—
DA4902
RR MEDICARE PTAN #
IL
01
—
P00286665
RR MEDICARE ID#
IL
Enumeration date
01/11/2006
Last updated
11/23/2020
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