Provider Demographics
NPI:1477315018
Name:WALKER, SETH
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36281 BRITTINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:DE
Mailing Address - Zip Code:19940-4230
Mailing Address - Country:US
Mailing Address - Phone:302-236-1248
Mailing Address - Fax:
Practice Address - Street 1:36281 BRITTINGHAM RD
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:DE
Practice Address - Zip Code:19940-4230
Practice Address - Country:US
Practice Address - Phone:302-236-1248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2255A2300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer