Provider Demographics
NPI:1659366631
Name:WALSH, LINDA AHLQUIST (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:AHLQUIST
Last Name:WALSH
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3718 NORRISVILLE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:JARRETTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21084-1419
Mailing Address - Country:US
Mailing Address - Phone:410-692-5292
Mailing Address - Fax:
Practice Address - Street 1:3718 NORRISVILLE RD
Practice Address - Street 2:SUITE C
Practice Address - City:JARRETTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21084-1419
Practice Address - Country:US
Practice Address - Phone:410-692-5292
Practice Address - Fax:410-557-4256
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2012-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0034208207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD466771900Medicaid
MD891L285EMedicare PIN
D73742Medicare UPIN
MD11286000000Medicare PIN