Provider Demographics
NPI:1902822448
Name:WALKER, SHERRIE LEE (MD)
Entity Type:Individual
Prefix:MS
First Name:SHERRIE
Middle Name:LEE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8988 LORTON STATION BLVD
Mailing Address - Street 2:#204
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4733
Mailing Address - Country:US
Mailing Address - Phone:703-339-0477
Mailing Address - Fax:703-339-9157
Practice Address - Street 1:8988 LORTON STATION BLVD
Practice Address - Street 2:#204
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4733
Practice Address - Country:US
Practice Address - Phone:703-339-0477
Practice Address - Fax:703-339-9157
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054987174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF35377Medicare UPIN
VA183023Medicare ID - Type Unspecified