Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | MD2004-0575 | NM |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | DR.0056502 | CO |
NPI | 1053405449 |
---|---|
Provider Name | Peter L Walinsky |
First Address | Colorado Springs, CO 80909-5533 |
Second Address | Colorado Springs, CO 80909-5533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 21/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
83171339 | (05) | NM |
G59484 | (02) |