MEDICARE: HARRY J WALTER DO PC

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	207Q00000X	Family Medicine Physician	15893	CO

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	:	1649475617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRY J WALTER DO PC

Provider Business Mailing Address
First Line	:	8380 ZUNI ST
Second Line	:	SUITE 200
City	:	WESTMINSTER
State	:	CO
Zip	:	80221-4778
Country	:	US
Telephone Number	:	303-286-1960
Fax Number	:	303-286-1964

Provider Business Practice Location Address
First Line	:	8380 ZUNI ST
Second Line	:	SUITE 200
City	:	WESTMINSTER
State	:	CO
Zip	:	80221-4778
Country	:	US
Telephone Number	:	303-286-1960
Fax Number	:	303-286-1964

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. MELISSA BLYTHE BROWN
Credential	:
Telephone Number	:	303-286-1960

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	12/08/2011

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