Provider Demographics
NPI:1669430872
Name:WALKER, KAREN DIETRICH (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:DIETRICH
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4410 WATERMELON RD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-5204
Mailing Address - Country:US
Mailing Address - Phone:205-345-1520
Mailing Address - Fax:205-345-1761
Practice Address - Street 1:4410 WATERMELON RD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-5204
Practice Address - Country:US
Practice Address - Phone:205-345-1520
Practice Address - Fax:205-345-1761
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2012-12-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL00026457207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I55560Medicare UPIN