Provider Demographics
NPI:1861492134
Name:WALKER, EDWIN (MD, MSPH)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD, MSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 CHAPMAN RD STE 205C
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5449
Mailing Address - Country:US
Mailing Address - Phone:302-533-7582
Mailing Address - Fax:302-533-7584
Practice Address - Street 1:260 CHAPMAN RD STE 205C
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5449
Practice Address - Country:US
Practice Address - Phone:302-533-7582
Practice Address - Fax:302-533-7584
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY228902084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C02498Medicare UPIN