Provider Demographics
NPI:1780662353
Name:VOIGT, WALTER JAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:JAVIER
Last Name:VOIGT
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-6770
Mailing Address - Fax:505-923-5354
Practice Address - Street 1:170 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NH
Practice Address - Zip Code:03584-3556
Practice Address - Country:US
Practice Address - Phone:603-788-2521
Practice Address - Fax:603-788-5027
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH11806208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009012Medicaid
NH30203044Medicaid
NHRE6769Medicare ID - Type Unspecified
VT1009012Medicaid