Osorio, Walter Raul

Osorio, Walter Raul is an sole proprietor health care provider with primary practice located at 621 Memorial Dr Ste 502 , South Bend IN 46601-1075. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Osorio, Walter Raul can be contacted via phone (574) 647-5875.

Contact Information

Primary practice address
621 Memorial Dr Ste 502 South Bend IN 46601-1075
Fax: (574) 647-5878
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 71013751A Indiana

Profile Details

NPI number 1811608334
LBN Legal business name Osorio, Walter Raul
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 6th, 2022
Last updated Jun 1st, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811608334 NPPES
Indiana MEDICAID 300075201

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