Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | D16834 | MD |
NPI | 1073549127 |
---|---|
Provider Name | Patrick Walsh |
First Address | Baltimore, MD 21264-4255 |
Second Address | Baltimore, MD 21287-0006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 20/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
711811200 | (05) | MD |
D77995 | (02) | MD |