Provider Demographics
NPI:1871656579
Name:MEYER, WALTER TERRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:TERRENCE
Last Name:MEYER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 30001
Mailing Address - Street 2:MSC 3529 NEW MEXICO STATE UNIVERSITY STUDENT HEALTH CEN
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88003-8001
Mailing Address - Country:US
Mailing Address - Phone:505-646-6510
Mailing Address - Fax:505-646-6428
Practice Address - Street 1:NEW MEXICO STATE UNIVERSITY STUDENT HEALTH CENTER
Practice Address - Street 2:MSC 3529 BOX 300001
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88003-8001
Practice Address - Country:US
Practice Address - Phone:505-646-6510
Practice Address - Fax:505-646-6428
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NM74205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine