Provider Demographics
NPI:1023109956
Name:FIERSON, WALTER MILES (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:MILES
Last Name:FIERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1245 W HUNTINGTON DRIVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007
Mailing Address - Country:US
Mailing Address - Phone:626-304-7081
Mailing Address - Fax:626-304-1078
Practice Address - Street 1:1245 W HUNTINGTON DRIVE
Practice Address - Street 2:SUITE 109
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007
Practice Address - Country:US
Practice Address - Phone:626-304-7081
Practice Address - Fax:626-304-1078
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2020-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG29165207W00000X, 207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWC29165CMedicare ID - Type Unspecified
A43969Medicare UPIN
CAW825Medicare PIN