MEDICARE: MICHAEL WALKOVICH DPM

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	213E00000X	Podiatrist	36003018	OH

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	:	1538162136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL WALKOVICH DPM

Provider Business Mailing Address
First Line	:	3055 W SYLVANIA AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-4135
Country	:	US
Telephone Number	:	419-473-0125
Fax Number	:	419-473-1230

Provider Business Practice Location Address
First Line	:	3055 W SYLVANIA AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-4135
Country	:	US
Telephone Number	:	419-473-0125
Fax Number	:	419-473-1230

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	08/05/2019

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