Provider Demographics
NPI:1629039516
Name:WALKER, MARY A (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:A
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 1:222 ALLEGHENY RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-1848
Mailing Address - Country:US
Mailing Address - Phone:412-767-5387
Mailing Address - Fax:412-828-6642
Practice Address - Street 1:222 ALLEGHENY RIVER BLVD
Practice Address - Street 2:
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-1848
Practice Address - Country:US
Practice Address - Phone:412-767-5387
Practice Address - Fax:412-828-6642
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050620L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001463268Medicaid
PA755220OtherBCBS
PA001463268Medicaid
PA755220OtherBCBS