Provider Demographics
NPI:1356419824
Name:WALKER, RONDI KATHLEEN (MD)
Entity type:Individual
Prefix:
First Name:RONDI
Middle Name:KATHLEEN
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3301 NEW MEXICO AVENUE NW
Mailing Address - Street 2:#252
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3610
Mailing Address - Country:US
Mailing Address - Phone:202-364-6673
Mailing Address - Fax:202-686-0257
Practice Address - Street 1:3301 NEW MEXICO AVENUE NW
Practice Address - Street 2:#252
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3610
Practice Address - Country:US
Practice Address - Phone:202-364-6673
Practice Address - Fax:202-686-0257
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD17911207Y00000X
MDD0041082208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F06035Medicare UPIN
680295Medicare ID - Type Unspecified