Individual
DR. ERIC THOMAS WALCHAK
Active
Individual
DR. ERIC THOMAS WALCHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
5101013546
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4618795
—
MI
01
—
5101013546
STATE LICENSE
MI
01
—
EW013546
BCBSM PIN
MI
01
—
P00145080
RAILROAD MEDICARE
MI
Enumeration date
11/03/2005
Last updated
10/17/2017
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