Provider Demographics
NPI:1881637775
Name:WALSH, MEGHAN MARY (MD MPH)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:MARY
Last Name:WALSH
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Gender:F
Credentials:MD MPH
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Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:OFFICE OF THE MEDICAL DIRECTOR, G2
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-3418
Mailing Address - Fax:612-904-4401
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:OFFICE OF THE MEDICAL DIRECTOR, G2
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-3418
Practice Address - Fax:612-904-4418
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2012-09-28
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Provider Licenses
StateLicense IDTaxonomies
MN48080208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
I37786Medicare UPIN