Provider Demographics
NPI:1356043103
Name:ASAH, WALTERS
Entity type:Individual
Prefix:MR
First Name:WALTERS
Middle Name:
Last Name:ASAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3689 JAY ST NE APT 102
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-1756
Mailing Address - Country:US
Mailing Address - Phone:240-615-7550
Mailing Address - Fax:
Practice Address - Street 1:3689 JAY ST NE APT 102
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1756
Practice Address - Country:US
Practice Address - Phone:240-615-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker