Provider Demographics
NPI:1487642278
Name:WALKER, ANGELA (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WALKER
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:NORTHSIDE HOSPITAL - MANAGED CARE DEPARTMENT
Mailing Address - Street 2:1000 JOHNSON FERRY RD NE
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342
Mailing Address - Country:US
Mailing Address - Phone:404-300-2476
Mailing Address - Fax:404-250-8010
Practice Address - Street 1:1800 NORTHSIDE FORSYTH DR STE 350
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-8483
Practice Address - Country:US
Practice Address - Phone:770-886-3555
Practice Address - Fax:770-205-6501
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2733207V00000X
GA073667207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149091402Medicaid
GA207V00000XOtherTAXONOMY
GA073667OtherSTATE LICENSE
GA1487642278OtherNPI
TX149091402Medicaid
TX8D7636Medicare PIN