Provider Demographics
NPI:1245279330
Name:WALKER, JERI A (MD)
Entity type:Individual
Prefix:
First Name:JERI
Middle Name:A
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 1:1 HARVARD RD
Mailing Address - Street 2:MCI SHIRLEY
Mailing Address - City:SHIRLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01464
Mailing Address - Country:US
Mailing Address - Phone:978-425-4341
Mailing Address - Fax:
Practice Address - Street 1:1 HARVARD RD
Practice Address - Street 2:MCI SHIRLEY
Practice Address - City:SHIRLEY
Practice Address - State:MA
Practice Address - Zip Code:01464
Practice Address - Country:US
Practice Address - Phone:978-425-4341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA540592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA34938Medicare UPIN
MAJ05046Medicare PIN