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General NPI Number Information
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NPI Number | 1306951751
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Entity Type | Individual
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Provider Name | WALTER G WARREN DPM
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Gender | Male
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 1239 E 4TH ST RD
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City | SEYMOUR
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State | IN
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Zip | 47274-1839
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Country | US
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Telephone | 812-524-3338
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Fax | 812-524-3337
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Provider Business Mailing Address
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Address Line | 7301 E 90TH ST STE 112
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-1282
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Country | US
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Telephone | 317-773-7787
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Fax | 317-773-2226
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 07000678
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License Number State | IN
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