Provider Demographics
NPI:1093888588
Name:WALTON, MAIA ALEES (MD)
Entity Type:Individual
Prefix:
First Name:MAIA
Middle Name:ALEES
Last Name:WALTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3070 WINDWARD PLZ
Mailing Address - Street 2:SUITE 333F
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-8771
Mailing Address - Country:US
Mailing Address - Phone:888-381-8556
Mailing Address - Fax:
Practice Address - Street 1:3070 WINDWARD PLZ
Practice Address - Street 2:SUITE 333F
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-8771
Practice Address - Country:US
Practice Address - Phone:888-381-8556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA755022080P0204X
GA68961208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics