Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | MD418011 | PA |
N | 208D00000X | General Practice Physician | MD418011 | PA |
NPI | 1215081138 |
---|---|
Provider Name | Angela Walker |
First Address | Collegeville, PA 19426-0302 |
Second Address | Collegeville, PA 19426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 10/09/2007 |