Provider Demographics
NPI:1962493239
Name:WALKER, WILLIAM ALFRED (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALFRED
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 RANDOLPH RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1200
Mailing Address - Country:US
Mailing Address - Phone:704-333-1259
Mailing Address - Fax:704-333-0371
Practice Address - Street 1:2015 RANDOLPH RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1200
Practice Address - Country:US
Practice Address - Phone:704-333-1259
Practice Address - Fax:704-333-0371
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29183208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8985352Medicaid
NC211251Medicare ID - Type Unspecified
NCC86961Medicare UPIN