Provider Demographics
NPI:1033301486
Name:WALSH CONDON, MARIE T (MD)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:T
Last Name:WALSH CONDON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:75 RIVERSIDE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155
Mailing Address - Country:US
Mailing Address - Phone:781-756-7273
Mailing Address - Fax:781-721-0725
Practice Address - Street 1:75 RIVERSIDE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155
Practice Address - Country:US
Practice Address - Phone:781-306-0200
Practice Address - Fax:781-306-0264
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2020-01-29
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Provider Licenses
StateLicense IDTaxonomies
MA243618207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine