Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 189578A | NY |
Y | 111NI0900X | Internist | 189578A | NY |
N | 207R00000X | Internist | MD039838E | PA |
N | 111NI0900X | Internist | MD039838E | PA |
NPI | 1003038274 |
---|---|
Provider Name | Dr. Marcellus Andre Walker |
First Address | New York, NY 10010-2417 |
Second Address | Brooklyn, NY 11207-3509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/12/2020 |