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
Phone: (417) 875-3000
Fax:
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1386817294 | NPPES |
Missouri | MEDICAID | 206427106 | |
Missouri | MEDICAID | 1386817294 |
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