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Individual

DR. NICHOLAS D. WALTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12605 E 16TH AVE, AURORA, CO 80045-2545
(720) 848-0000
Mailing address
PO BOX 876, AURORA, CO 80040-0876
(303) 493-7000

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
46815
CO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
46815
CO
207RP1001X
Pulmonary Disease Physician
46815
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04594040
CO
05
57174725
CO
Enumeration date
07/19/2007
Last updated
11/17/2011
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