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NPI Code Detail

MEDICARE: MR. WALTER H DEARMITT MD

MEDICARE: MR. WALTER H DEARMITT MD
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
1207Q00000XFamily Medicine Physician01023855AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000512079OTHERANTHEM
2085024OTHERSIHO

General Provider Information

NPI Number : 1871527697
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WALTER H DEARMITT MD
Provider Business Mailing Address
First Line : 2320 N PARK DR
Second Line : SUITE A
City : COLUMBUS
State : IN
Zip : 47203-4482
Country : US
Telephone Number : 812-314-0170
Fax Number : 812-314-0171
Provider Business Practice Location Address
First Line : 2320 NORTH PARK DRIVE
Second Line : SUITE A
City : COLUMBUS
State : IN
Zip : 47203-2036
Country : US
Telephone Number : 812-314-0170
Fax Number : 812-314-0171
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 10/10/2007

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