Healthcare Provider Details

I. General information

NPI: 1932295607
Provider Name (Legal Business Name): WALTER EDWARD APP M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 11/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 NEWBURG RD SUITE 150
LOUISVILLE KY
40218-2497
US

IV. Provider business mailing address

3430 NEWBURG RD SUITE 150
LOUISVILLE KY
40218-2497
US

V. Phone/Fax

Practice location:
  • Phone: 502-459-9127
  • Fax: 502-459-2156
Mailing address:
  • Phone: 502-459-9127
  • Fax: 502-459-2156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number24136
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberKY24136
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number24136
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: