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General NPI Number Information
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NPI Number | 1447680301
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Entity Type | Organization
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Legal Business Name | WALTER L. FLETSCHER, M.D., INC.
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Dates
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Enumeration Date | 11/13/2013
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Last Update Date | 11/13/2013
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Provider Practice Location Address
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Address Line | 2510 AIRPARK DR SUITE 302
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City | REDDING
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State | CA
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Zip | 96001-2449
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Country | US
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Telephone | 530-241-9966
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Fax | 530-241-9783
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Provider Business Mailing Address
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Address Line | 2510 AIRPARK DR SUITE 302
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City | REDDING
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State | CA
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Zip | 96001-2449
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Country | US
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Telephone | 530-241-9966
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Fax | 530-241-9783
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Authorized Official
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Title or Position | PRESIDENT
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Name | WALTER LYLE FLETSCHER
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Credential | M.D.
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Telephone | 530-949-4128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G48644
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License Number State | CA
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