Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 35063852 | OH |
NPI | 1003917568 |
---|---|
Provider Name | David Walker |
First Address | Cleveland, OH 44190-1587 |
Second Address | Parma, OH 44129-5464 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 08/07/2007 |