Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 14671 | MD |
Y | 213EG0000X | General Practice | 14671 | MD |
NPI | 1003144346 |
---|---|
Provider Name | Dr. Alan David Walker |
First Address | Havre De Grace, MD 21078-2103 |
Second Address | Havre De Grace, MD 21078-3330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2009 |
Last Update Date | 25/11/2009 |