Individual
DR. RALPH T WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
(616) 364-7347
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
(616) 364-7347
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5101007679
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050054288
RAILROAD MEDICARE
MI
01
—
050D110480
BCBS GROUP BILL PIN
MI
05
—
3318284
—
MI
01
—
5410074
BCBS PIN
MI
01
—
CE1952
RAILROAD GROUP
MI
01
—
RW007679
BCBS LICENSE
MI
Enumeration date
04/11/2006
Last updated
03/09/2010
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