Provider Demographics
NPI:1619966884
Name:WALSH, CHRISTOPHER J (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:WALSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6635 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-2354
Mailing Address - Country:US
Mailing Address - Phone:770-968-1323
Mailing Address - Fax:770-968-4556
Practice Address - Street 1:6635 LAKE DR
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-2354
Practice Address - Country:US
Practice Address - Phone:770-968-1323
Practice Address - Fax:770-968-4556
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA051418207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF29740Medicare UPIN
GA20BBFMSMedicare PIN