Provider Demographics
NPI:1538132568
Name:WALSH, MARTHA M (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:M
Last Name:WALSH
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Gender:F
Credentials:MD
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Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR
Mailing Address - Street 2:PO BOX 0446 LOBBY J
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:5333 MCAULEY DR
Practice Address - Street 2:SUITE 2110
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1014
Practice Address - Country:US
Practice Address - Phone:734-712-3967
Practice Address - Fax:734-712-4243
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2017-03-13
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Provider Licenses
StateLicense IDTaxonomies
MI4301074364207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH87513Medicare UPIN