Provider Demographics
NPI:1083245047
Name:WALTERS, ZACHARY RYAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:RYAN
Last Name:WALTERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33920 23 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-4005
Mailing Address - Country:US
Mailing Address - Phone:585-725-3900
Mailing Address - Fax:
Practice Address - Street 1:33920 23 MILE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-4005
Practice Address - Country:US
Practice Address - Phone:586-725-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302041903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist