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1083735658 NPI number — SAM J WALTERS NMD

NPI Number: 1083735658
Health Care Provider/Practitioner: SAM J WALTERS NMD

Information about “1083735658” NPI (SAM J WALTERS NMD) exists in 1083735658 in HTML format HTML  |  1083735658 in plain Text format TXT  |  1083735658 in PDF (Portable Document Format) PDF  |  1083735658 in an XML format XML  formats.

NPI Number : 1083735658 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1083735658",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WALTERS",
    "FirstName": "SAM",
    "MiddleName": "J",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "NMD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "10901 E KAREN DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SCOTTSDALE",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85255-1818",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "480-946-9222",
    "MailingAddressFaxNumber": "480-946-9226",
    "FirstLinePracticeLocationAddress": "8070 E MORGAN TRL",
    "SecondLinePracticeLocationAddress": "SUITE 200",
    "PracticeLocationAddressCityName": "SCOTTSDALE",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85258-1227",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "480-946-9222",
    "PracticeLocationAddressFaxNumber": "480-946-9226",
    "EnumerationDate": "04/02/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "175F00000X",
        "TaxonomyName": "Naturopath",
        "LicenseNumber": "98-528",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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