Provider Demographics
NPI:1992585632
Name:WEST, WALTER D II
Entity type:Individual
Prefix:MR
First Name:WALTER
Middle Name:D
Last Name:WEST
Suffix:II
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 1:26151 LAKE SHORE BLVD APT 2122
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-1160
Mailing Address - Country:US
Mailing Address - Phone:440-444-4866
Mailing Address - Fax:
Practice Address - Street 1:26151 LAKE SHORE BLVD APT 2122
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-1160
Practice Address - Country:US
Practice Address - Phone:440-444-4866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide