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NPI Code Detail

MEDICARE: DR. SHAWN WILLIAM WALLS DPM

MEDICARE: DR. SHAWN WILLIAM WALLS 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
1213ES0103XFoot & Ankle Surgery Podiatrist59000193OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952433203
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHAWN WILLIAM WALLS DPM
Provider Business Mailing Address
First Line : 25 MERCHANT STREET
Second Line : SUITE 220
City : CINCINNATI
State : OH
Zip : 45246-3740
Country : US
Telephone Number : 513-385-7733
Fax Number : 513-385-7703
Provider Business Practice Location Address
First Line : 5463 N BEND RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-7620
Country : US
Telephone Number : 513-385-7733
Fax Number : 513-385-7703
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 12/16/2016

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