Provider Demographics
NPI:1750499620
Name:WALKER, GENA
Entity Type:Individual
Prefix:
First Name:GENA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MONTEFIORE HOSPITAL, SUITE G100
Mailing Address - Street 2:200 LOTHROP ST
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MONTEFIORE HOSPITAL, SUITE G100
Practice Address - Street 2:200 LOTHROP ST
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213
Practice Address - Country:US
Practice Address - Phone:412-692-4882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD420359207R00000X
SCTL27311207R00000X
NC2007-00966207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5907228Medicaid
NC1750499620Medicaid
SC273117Medicaid
SC273117Medicaid
SCAA0533Medicare PIN
I11500Medicare UPIN
NC5907228Medicaid
NC2069917AMedicare PIN