Provider Demographics
NPI:1558374736
Name:WALKER, KIMBERLY BURESH (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:BURESH
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 1:7493 RIGHT FLANK RD STE 400
Mailing Address - Street 2:ASHCAKE FAMILY PHYSICIANS
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-3846
Mailing Address - Country:US
Mailing Address - Phone:804-559-2916
Mailing Address - Fax:804-559-9206
Practice Address - Street 1:7493 RIGHT FLANK RD STE 400
Practice Address - Street 2:ASHCAKE FAMILY PHYSICIANS
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-3846
Practice Address - Country:US
Practice Address - Phone:804-559-2916
Practice Address - Fax:804-559-9206
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2016-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101233577207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010176271Medicaid
VA008213H48Medicare PIN
I22598Medicare UPIN