Individual
DR. WALTER AUGUST MINAERT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21017 STATE ROUTE 12F, WATERTOWN, NY 13601-1078
(315) 782-1990
(315) 782-1037
Mailing address
21017 STATE ROUTE 12F, WATERTOWN, NY 13601-1078
(315) 782-1990
(315) 782-1037
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
1227821
NY
208D00000X
General Practice Physician
122792
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00585011
—
NY
Enumeration date
06/26/2006
Last updated
03/07/2023
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