Provider Demographics
NPI:1336600634
Name:WALEK, JOSHUA ROBERT (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ROBERT
Last Name:WALEK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4975 NORTH PALMER STREET BLDG 85T FIRST FLOOR ROOM 1B15
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-0001
Mailing Address - Country:US
Mailing Address - Phone:301-319-7016
Mailing Address - Fax:
Practice Address - Street 1:4975 NORTH PALMER STREET BLDG 85T FIRST FLOOR ROOM 1B15
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-1212
Practice Address - Country:US
Practice Address - Phone:301-319-7016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV009230152W00000X
VA0618003085152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist