Provider Demographics
NPI:1659693885
Name:WALKER, .NADINE VICTORIA (MD)
Entity Type:Individual
Prefix:DR
First Name:.NADINE
Middle Name:VICTORIA
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 1:4402 15TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-7024
Mailing Address - Country:US
Mailing Address - Phone:202-723-3265
Mailing Address - Fax:
Practice Address - Street 1:4924 HAMLET CT
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-2205
Practice Address - Country:US
Practice Address - Phone:202-723-3265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA20617207R00000X, 207RA0401X, 2083P0500X, 2083P0901X, 2084P0800X, 2084P0015X, 103TP0016X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional