Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 0S007169L | PA |
NPI | 1053349779 |
---|---|
Provider Name | Dr. Donald Arthur Walters |
First Address | Butler, PA 16001-1801 |
Second Address | Butler, PA 16001-1801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 11/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0016474610008 | (05) | PA |
G35767 | (02) | PA |