Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | MD437792 | PA |
N | 2086S0120X | Pediatric Surgery | R3615 | TX |
NPI | 1316145113 |
---|---|
Provider Name | Dr. Ryan Mcmahon Walk |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-9800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 03/01/2022 |