Provider Demographics
NPI:1659637957
Name:WALKER, FELICIA L (MD)
Entity type:Individual
Prefix:MISS
First Name:FELICIA
Middle Name:L
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 1:1122 LADY ST # 1312
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3218
Mailing Address - Country:US
Mailing Address - Phone:803-871-0081
Mailing Address - Fax:802-214-5892
Practice Address - Street 1:1122 LADY ST # 1312
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3218
Practice Address - Country:US
Practice Address - Phone:803-871-0081
Practice Address - Fax:802-214-5892
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC611622084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC611626Medicaid