Provider Demographics
NPI:1538299953
Name:WALKER, STANLEY ROBERT (M D)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:ROBERT
Last Name:WALKER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CORPORATE DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-2664
Mailing Address - Country:US
Mailing Address - Phone:610-252-0962
Mailing Address - Fax:610-252-4060
Practice Address - Street 1:21 CORPORATE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-2664
Practice Address - Country:US
Practice Address - Phone:610-252-0962
Practice Address - Fax:610-252-4060
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036484L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02298300OtherCAPITAL BLUE CROSS
PA232219830OtherAETNA
PA0006493720003Medicaid
PA110168151OtherRAILROAD MEDICARE
PA000113191OtherHIGHMARK BLUE SHIELD
PA00113191OtherINDEPENDENCE BLUE CROSS
PAA13191OtherAMERIHEALTH
NJ087238TQ4OtherEMPIRE
IL232219830TOtherBLUE CROSS BLUE SHIELD
PA000000319438OtherANTHEM BCBS
PA232219830OtherTRICARE
PA85523OtherAETNA HMO
PA02298300OtherCAPITAL BLUE CROSS
PA000000319438OtherANTHEM BCBS
PA02298300OtherCAPITAL BLUE CROSS