Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 4301045261 | MI |
N | 207PE0004X | Emergency Medical Services | 4301045261 | MI |
NPI | 1083673081 |
---|---|
Provider Name | Dr. Nancy Z Walter |
First Address | Commerce, MI 48382-2201 |
Second Address | Commerce Township, MI 48382-2201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 17/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102971889 | (05) | MI |
B46610 | (02) | MI |
NL045261 | BC/BS OF MI (01) | MI |