Provider Demographics
NPI:1467885475
Name:WALKER, DWAYNE OM (MD)
Entity Type:Individual
Prefix:DR
First Name:DWAYNE
Middle Name:OM
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4652 PARTNERS PL
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-2989
Mailing Address - Country:US
Mailing Address - Phone:513-603-8720
Mailing Address - Fax:513-603-8739
Practice Address - Street 1:4652 PARTNERS PL
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-2989
Practice Address - Country:US
Practice Address - Phone:513-603-8720
Practice Address - Fax:513-603-8739
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH127305207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine