Provider Demographics
NPI:1003926726
Name:WALKER, FREDERICK WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:WILLIAM
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2005 ROCK SPRING RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2621
Mailing Address - Country:US
Mailing Address - Phone:410-836-0909
Mailing Address - Fax:410-893-2325
Practice Address - Street 1:2005 ROCK SPRING RD
Practice Address - Street 2:SUITE 5
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2621
Practice Address - Country:US
Practice Address - Phone:410-836-0909
Practice Address - Fax:410-893-2325
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDDOO20463208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC49340Medicare UPIN