Individual
DR. HENRY J WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2355 POPLAR LEVEL RD, SUITE G1-11, LOUISVILLE, KY 40217-1395
(502) 636-8121
(502) 636-8128
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21554
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000057043V
HUMANA- NCMA
KY
05
—
100016220
—
KY
01
—
119014
SIHO- NCMA
KY
01
—
2543254
CIGNA- NCMA
KY
01
—
50031914
PASSPORT- NCMA
KY
05
—
64215544
—
KY
01
—
692787
ANTHEM- NCMA
KY
01
—
P00912083
RAILROAD MEDICARE- NCMA
KY
Enumeration date
01/05/2007
Last updated
12/05/2018
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