Walter D. Devault III M.D. P.a.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME79492 Issued in FL

Legal business name

WALTER D. DEVAULT III M.D. P.A.

Practice address

816 SE Ocean Blvd
Stuart, FL 34994-2428

Phone

(772) 286-5551

Fax

(772) 286-3026

NPI assigned

Nov 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Walter D Devault III, M.D.

Title

Owner

Phone

(772) 286-5551

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1023299609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 SE OCEAN BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942428",
            "telephone_number": "772-286-5551",
            "fax_number": "772-286-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 SE OCEAN BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942428",
            "telephone_number": "772-286-5551",
            "fax_number": "772-286-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER D. DEVAULT III M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-23",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "DEVAULT",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-286-5551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME79492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35751",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samanthia Wash Waller
• Nina Wallick, DMD
• Berdashia Moesha Walls
• Laneil Nicola Walls
• Jordan Walrond
• Hannah Marie Walters
• Judith R. Walters, SLP-CCC, ATP
• Lisa Marie Walters
• Patrick Walters
• Shawnya Walters, PHARMD

• Internal Medicine Physician in Stuart, FL
• Providers in Stuart, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.