Provider Demographics
NPI:1689667818
Name:KLATT, WALTER A (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:A
Last Name:KLATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3614 MANCHESTER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-2160
Mailing Address - Country:US
Mailing Address - Phone:330-644-2234
Mailing Address - Fax:
Practice Address - Street 1:3614 MANCHESTER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-2159
Practice Address - Country:US
Practice Address - Phone:330-644-2234
Practice Address - Fax:330-644-7116
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35065024207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0923120Medicaid
OH0923120Medicaid