Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 026953 | GA |
Y | 208600000X | Surgeon | 026953 | GA |
N | 2086S0102X | Surgical Critical Care | 026953 | GA |
NPI | 1356382345 |
---|---|
Provider Name | Dr. Mark Lamont Walker |
First Address | Atlanta, GA 30315-7129 |
Second Address | Atlanta, GA 30315-7129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 26/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000298284E | (05) | GA |
D41303 | (02) | GA |