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NPI Code Detail

MEDICARE: MR. STEVEN J WALTER PA-C

MEDICARE: MR. STEVEN J WALTER PA-C
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
1363A00000XPhysician AssistantPA9102944FL
2363A00000XPhysician AssistantPA680AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518956200
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEVEN J WALTER PA-C
Provider Business Mailing Address
First Line : 4005 PEBBLECREEK LN
Second Line :
City : DOTHAN
State : AL
Zip : 36303-1439
Country : US
Telephone Number : 334-699-5535
Fax Number :
Provider Business Practice Location Address
First Line : 4370 W MAIN ST
Second Line :
City : DOTHAN
State : AL
Zip : 36305-1056
Country : US
Telephone Number : 334-793-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 09/11/2012

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