Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 35-080813 | OH |
Y | 2086S0120X | Pediatric Surgery | 54706 | MA |
NPI | 1497771141 |
---|---|
Provider Name | Walter J Chwals |
First Address | Boston, MA 02111-1552 |
Second Address | Boston, MA 02111-1552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 29/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000204731 | UNISON (01) | OH |
000000503637 | ANTHEM (01) | |
1012234150001 | PENNSYLVANIA MEDICAID (01) | PA |
2319539 | (05) | OH |
2319539 | BCMH (01) | OH |
363426 | WELLCARE (01) | OH |
3810009981 | WEST VIRGINIA MEDICAID (01) | WV |
5904683 | AETNA (01) | |
734678 | BUCKEYE (01) | OH |
D92681 | (02) |