Provider Demographics
NPI:1245258417
Name:FRANK, WALTER R III (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:R
Last Name:FRANK
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:MANAGED CARE DEPT
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:580 BLACK RIVER RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-3302
Practice Address - Country:US
Practice Address - Phone:843-527-2421
Practice Address - Fax:843-527-5079
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2016-12-29
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Provider Licenses
StateLicense IDTaxonomies
SCMD17277208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4522Medicaid
SC5115235OtherAETNA
SC000000257336OtherUNISON HEALTH PLAN
SC771580OtherWELLCARE
SCP00386778OtherRAILROAD MEDICARE
SC4515967OtherCIGNA
SC80023007OtherSELECT HEALTH
SCF798048568Medicare PIN
SC000000257336OtherUNISON HEALTH PLAN