Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 23523 | AL |
NPI | 1184664229 |
---|---|
Provider Name | Andrew B. Walker |
First Address | Mobile, AL 36640-0480 |
Second Address | Mobile, AL 36604-3304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 16/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00122509 | (05) | MS |
1431257 | (05) | LA |
17-10541 | UNITED HEALTH CARE (01) | AL |
51097753 | BLUE CROSS (01) | AL |
51097754 | BLUE CROSS (01) | AL |
B95823 | (02) |