Walters, Michael Shane

Walters, Michael Shane is an individual health care provider with primary practice located at 1001 E Primrose St , Springfield MO 65807-5155. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neuroradiology, which is considered as his primary health care specialty. Walters, Michael Shane can be contacted via phone (417) 875-3000.

Contact Information

Primary practice address
1001 E Primrose St Springfield MO 65807-5155
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X 2009005099 Missouri

Profile Details

NPI number 1386817294
LBN Legal business name Walters, Michael Shane
Credentials MD, MPH
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2008
Last updated Dec 27th, 2018 - about 7 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 1386817294 NPPES
Missouri MEDICAID 206427106
Missouri MEDICAID 1386817294

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