Provider Demographics
NPI:1710973730
Name:WALSH, STEVEN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:WALSH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 116171
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-6171
Mailing Address - Country:US
Mailing Address - Phone:800-919-1190
Mailing Address - Fax:706-737-2271
Practice Address - Street 1:3000 HOSPITAL BLVD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4915
Practice Address - Country:US
Practice Address - Phone:770-751-2500
Practice Address - Fax:770-751-2609
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2007-10-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA027685207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D41314Medicare UPIN