Provider Demographics
NPI:1083716823
Name:WALKER, MARK ALLAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALLAN
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANENTE MEDICARE ENROLLMENT
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:
Practice Address - Street 1:1701 TWIN SPRINGS RD
Practice Address - Street 2:KAISER PERMANENTE SOUTH BALTIMORE COUNTY MEDICAL CENTER
Practice Address - City:HALETHORPE
Practice Address - State:MD
Practice Address - Zip Code:21227-3553
Practice Address - Country:US
Practice Address - Phone:410-737-5540
Practice Address - Fax:410-737-5531
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2013-10-29
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Provider Licenses
StateLicense IDTaxonomies
MDD0037239207RE0101X
VA0101250822207RE0101X
DCMD039279207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
F22495Medicare UPIN