Provider Demographics
NPI:1578564142
Name:WALKER, WILLIAM P III (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:P
Last Name:WALKER
Suffix:III
Gender:M
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:PO BOX 928
Mailing Address - Street 2:
Mailing Address - City:SHALLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28459-0928
Mailing Address - Country:US
Mailing Address - Phone:910-755-6232
Mailing Address - Fax:910-755-5984
Practice Address - Street 1:712 VILLAGE RD SW
Practice Address - Street 2:SUITE 206
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-3448
Practice Address - Country:US
Practice Address - Phone:910-755-6232
Practice Address - Fax:910-755-5984
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500754207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC304049Medicaid
NC561931514OtherUNITED HEALTHCARE
NC85373OtherBCBS
NC8985373Medicaid
G14107Medicare UPIN
NC2216748Medicare ID - Type Unspecified
SC304049Medicaid
NC2216748Medicare PIN