Provider Demographics
NPI:1730105503
Name:WALKER, GREGORY E (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:E
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1789 S BRADDOCK AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218-1842
Mailing Address - Country:US
Mailing Address - Phone:412-244-8760
Mailing Address - Fax:412-244-8640
Practice Address - Street 1:1789 S BRADDOCK AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1842
Practice Address - Country:US
Practice Address - Phone:412-244-8760
Practice Address - Fax:412-244-8640
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058531L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016401200002Medicaid
PA902178Medicare ID - Type Unspecified
G50320Medicare UPIN