Provider Demographics
NPI:1902834997
Name:WALTON, ANNE N (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:N
Last Name:WALTON
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 1:665 CHURCHMANS RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-1918
Mailing Address - Country:US
Mailing Address - Phone:302-738-7054
Mailing Address - Fax:302-731-7100
Practice Address - Street 1:665 CHURCHMANS RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1918
Practice Address - Country:US
Practice Address - Phone:302-738-7054
Practice Address - Fax:302-731-7100
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10006853207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE00B971A91Medicare PIN