Provider Demographics
NPI:1174506604
Name:BUHL, WALTER R (MD)
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:R
Last Name:BUHL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 22075
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97269-2075
Mailing Address - Country:US
Mailing Address - Phone:503-659-4777
Mailing Address - Fax:503-652-5223
Practice Address - Street 1:3033 SE MONROE ST
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6636
Practice Address - Country:US
Practice Address - Phone:503-659-4988
Practice Address - Fax:503-659-4730
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2021-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD08309207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR014076Medicaid
OR080063859OtherRR MEDICARE
ORC92313Medicare UPIN