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WALTERS SAMUEL R MD

Debarred entity

WALTERS SAMUEL R MD is an entity of interest. It has not been found on international sanctions lists.

Type	Legal entity				[sources]
Name	WALTERS SAMUEL R MD · WALTERS, SAMUEL R.				[sources]
Legal form	not available				[sources]
Country	United States of America				[sources]
ID Number	`00115662`				[sources]
NPI	`1144368606`				[sources]
Sector	MD · Physician				[sources]
Status	not available				[sources]
Address	215 FOX HILL RUN, ROCK TAVERN, NY 12575				[sources]
Last change	2025-05-08	Last processed	2025-10-01	First seen	2024-09-02

Sanctions
Country	Authority	Program	Start date	End date
United States of America	New York State Office of the Medicaid Inspector General		2016-09-22	-

Address
Full address	Country
215 FOX HILL RUN, ROCK TAVERN, NY 12575	United States of America

Medical providers deemed ineligible to participate in New York State's Medicaid program.

United States of America · OMIG

Medical providers disqualified from participating in New Jersey State's Medicaid program.

United States of America · OIFP

Source data IDs: us-mednj-7e6f40fbbfe5d7ae061ec1c1829eeae35bf71d1b · us-medny-5124eef9398a81476547f74a1493486319203e4f

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