Provider Demographics
NPI:1790198430
Name:WALKS, IVAN (MD)
Entity Type:Individual
Prefix:
First Name:IVAN
Middle Name:
Last Name:WALKS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8737 COLESVILLE RD STE 310
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3921
Mailing Address - Country:US
Mailing Address - Phone:301-583-5195
Mailing Address - Fax:202-899-4222
Practice Address - Street 1:8737 COLESVILLE RD STE 310
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3921
Practice Address - Country:US
Practice Address - Phone:301-583-5195
Practice Address - Fax:202-899-4222
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2019-04-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD779972084P0800X
DCMD325972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry