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NPI Code Detail

MEDICARE: PETER A WALTS MD

MEDICARE: PETER A WALTS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician01059506AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00145833OTHERRAILROAD MEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000341622OTHERBCBS PIN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417982620
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER A WALTS MD
Provider Business Mailing Address
First Line : 10590 N MERIDIAN ST # 105
Second Line :
City : CARMEL
State : IN
Zip : 46290-1028
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10590 N MERIDIAN ST # 105
Second Line :
City : CARMEL
State : IN
Zip : 46290-1028
Country : US
Telephone Number : 317-583-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 05/20/2022

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Directions to “ PETER A WALTS MD” Practice Location

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