Walters, Laura Marie

Walters, Laura Marie is an individual health care provider with primary practice located at 1911 E Rezanof Dr , Kodiak AK 99615-6602. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Walters, Laura Marie can be contacted via phone (907) 481-5000.

Contact Information

Primary practice address
1911 E Rezanof Dr Kodiak AK 99615-6602
Fax: (907) 481-5030
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4067 Alaska

Profile Details

NPI number 1831162825
LBN Legal business name Walters, Laura Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Dec 6th, 2017 - about 9 years ago

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 1831162825 NPPES
Other 920088665 CLINIC TAX ID
MEDICAID MD4067 CLINIC TAX ID

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