Provider Demographics
NPI:1538126867
Name:WALZ, CARA SUE (MD)
Entity Type:Individual
Prefix:MS
First Name:CARA
Middle Name:SUE
Last Name:WALZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHARISSA
Other - Middle Name:SUE
Other - Last Name:CURTISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2854 HIGHWAY 55 STE 130
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-1776
Mailing Address - Country:US
Mailing Address - Phone:651-224-4930
Mailing Address - Fax:651-842-3391
Practice Address - Street 1:1997 SLOAN PL STE 17
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55117-2051
Practice Address - Country:US
Practice Address - Phone:651-772-6251
Practice Address - Fax:651-294-9661
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN39607207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN847316100Medicaid
G59251Medicare UPIN
MN847316100Medicaid