Provider Demographics
NPI:1962442590
Name:WALTER, FRANK L (MD)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:L
Last Name:WALTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2817 NEW PINERY ROAD
Mailing Address - Street 2:PO BOX 387
Mailing Address - City:PORTAGE
Mailing Address - State:WI
Mailing Address - Zip Code:53901-0387
Mailing Address - Country:US
Mailing Address - Phone:608-742-4131
Mailing Address - Fax:608-745-0451
Practice Address - Street 1:2817 NEW PINERY ROAD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:WI
Practice Address - Zip Code:53901-0387
Practice Address - Country:US
Practice Address - Phone:608-742-4131
Practice Address - Fax:608-745-0451
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI48878207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34837700Medicaid
WI131350048Medicare PIN