Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YP0228X | Pediatric Otolaryngology | 25MA09871200 | NJ |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 25MA09871200 | NJ |
NPI | 1457675589 |
---|---|
Provider Name | Ryan D Walker |
First Address | Cherry Hill, NJ 08034 |
Second Address | Voorhees, NJ 08043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2010 |
Last Update Date | 28/09/2021 |