Provider Demographics
NPI:1134540347
Name:DRS. WALTER & RINGEMAN, P.A.
Entity type:Organization
Organization Name:DRS. WALTER & RINGEMAN, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:336-768-9881
Mailing Address - Street 1:3020 MAPLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-4012
Mailing Address - Country:US
Mailing Address - Phone:336-768-9881
Mailing Address - Fax:336-768-6066
Practice Address - Street 1:3020 MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-4012
Practice Address - Country:US
Practice Address - Phone:336-768-9881
Practice Address - Fax:336-768-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC41281223P0106X, 1223S0112X
NC96051223P0106X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5921132Medicaid
NC8998854Medicaid
P01172603Medicare PIN
NC5921132Medicaid