MEDICARE: DR. DANA MARIE WALTERS M.D.

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
1	207RN0300X	Nephrology Physician	15633R	LA

Other Identifiers

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

General Provider Information

NPI Number	:	1023048956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANA MARIE WALTERS M.D.

Provider Business Mailing Address
First Line	:	118 SHERWOOD FOREST DR
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-3717
Country	:	US
Telephone Number	:	504-512-0332
Fax Number	:

Provider Business Practice Location Address
First Line	:	1542 TULANE AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2865
Country	:	US
Telephone Number	:	504-568-8655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/08/2007

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