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Individual

DR. WALTER E FRITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1002 S EDGEWOOD DR, KNOX, IN 46534-8226
(574) 772-2188
(574) 772-2190
Mailing address
1002 S EDGEWOOD DR, KNOX, IN 46534-8226
(574) 772-2188
(574) 772-2190

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01024309A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000083056
BLUE CROSS PIN NUMBER
IN
01
01024309A
WALTER FRITZ,M.D. LICENSE
IN
05
100225090A
IN
05
200020860A
IN
05
200897290
IN
01
351301967
TAX ID
IN
01
50000720A
CORPORATION LICENSE
IN
01
87-0778393
TAX IDENTIFICATION NUMBER
IN
Enumeration date
06/05/2006
Last updated
10/20/2020
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