Provider Demographics
NPI:1932295607
Name:APP, WALTER EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:EDWARD
Last Name:APP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3430 NEWBURG RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-2497
Mailing Address - Country:US
Mailing Address - Phone:502-459-9127
Mailing Address - Fax:502-459-2156
Practice Address - Street 1:3430 NEWBURG RD
Practice Address - Street 2:SUITE 150
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-2497
Practice Address - Country:US
Practice Address - Phone:502-459-9127
Practice Address - Fax:502-459-2156
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2016-11-10
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Provider Licenses
StateLicense IDTaxonomies
KYKY24136207RP1001X
KY24136207RC0200X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7178282OtherAETNA
KY200003130OtherINDIANA MEDICAID
KY64241367Medicaid
KY110033039OtherRAILROAD MEDICARE
KY00150004Medicare PIN
KY7178282OtherAETNA
KYC71478Medicare UPIN
KY1200915Medicare PIN
KY200003130OtherINDIANA MEDICAID