Individual
DR. SUSAN ANNE WALSTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4601 HEATHERWIND DR, APT. D, FORT WAYNE, IN 46815-7135
(260) 420-1433
(260) 745-3643
Mailing address
4601 HEATHERWIND DR, APT. D, FORT WAYNE, IN 46815-7135
(260) 420-1433
(260) 745-3643
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01034161A
IN
Other
Enumeration date
04/28/2011
Last updated
04/28/2011
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