Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MAO623320 | NJ |
NPI | 1114981172 |
---|---|
Provider Name | Dr. Camille Dorothy Walker |
First Address | South Orange, NJ 07079-2636 |
Second Address | South Orange, NJ 07079-2636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 08/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6861601 | (05) | NJ |
G24075 | (02) |