Provider Demographics
NPI:1891743803
Name:ATLAS, WALTER GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:GERARD
Last Name:ATLAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6035 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3256
Mailing Address - Country:US
Mailing Address - Phone:704-295-3000
Mailing Address - Fax:704-838-8494
Practice Address - Street 1:6035 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3256
Practice Address - Country:US
Practice Address - Phone:704-295-3000
Practice Address - Fax:704-838-8494
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34946207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2278670OtherAETNA HMO EPO SELECT
NC112698OtherWELLNESS
NC12173OtherBCBS
NC23454OtherPARTNERS
SC776616OtherWELLCARE
NC96121OtherMEDCOST
NC12191OtherBCBS MEDPOINT
NC8912173Medicaid
SCN34946Medicaid
SC20094029OtherSELECT HEALTH OF SC/FIRST CHOICE
040014824OtherRAILROAD MEDICARE
NC23454OtherCOMMUNITY EYE CARE
NC5371503OtherAETNA
SC20094029OtherSELECT HEALTH OF SC/FIRST CHOICE
NC0264730008Medicare NSC
040014824OtherRAILROAD MEDICARE
2167606CMedicare PIN