Provider Demographics
NPI:1972509255
Name:WALCHER, DAVID J (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:WALCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6545 FRANCE AVENUE SOUTH
Mailing Address - Street 2:SUITE 510
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435
Mailing Address - Country:US
Mailing Address - Phone:952-927-7079
Mailing Address - Fax:952-920-9758
Practice Address - Street 1:6545 FRANCE AVENUE SOUTH
Practice Address - Street 2:SUITE 510
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435
Practice Address - Country:US
Practice Address - Phone:952-927-7079
Practice Address - Fax:952-920-9758
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN25762207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN175803900Medicaid
MN110007145OtherMEDICARE
MN110007145Medicare ID - Type Unspecified
MN110007145OtherMEDICARE