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NPI Code Detail

MEDICARE: DR. WALTER ALAN ANDREWS D.D.S.

MEDICARE: DR. WALTER ALAN ANDREWS D.D.S.
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
11223G0001XGeneral Practice DentistryDD 1435NM

Other Identifiers

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

General Provider Information

NPI Number : 1588645592
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WALTER ALAN ANDREWS D.D.S.
Provider Business Mailing Address
First Line : 1419 S SANTA BARBARA ST
Second Line :
City : DEMING
State : NM
Zip : 88030-5361
Country : US
Telephone Number : 505-546-0415
Fax Number : 505-546-0470
Provider Business Practice Location Address
First Line : 1419 S SANTA BARBARA ST
Second Line :
City : DEMING
State : NM
Zip : 88030-5361
Country : US
Telephone Number : 505-546-0415
Fax Number : 505-546-0470
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 07/08/2007

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