Individual
BENNETT S WALSTATTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1202 W OAK ST, GREENVILLE, MI 48838-2155
(616) 754-2944
(616) 754-2999
Mailing address
1202 W OAK ST, GREENVILLE, MI 48838-2155
(616) 754-2944
(616) 754-2999
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
BW064603
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3443068
—
MI
Enumeration date
10/04/2006
Last updated
05/31/2012
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