MEDICARE: DR. MICHAEL J WALKER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	2375	NV

General Provider Information

NPI Number	:	1073543252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J WALKER DDS

Provider Business Mailing Address
First Line	:	2901 LA MESA DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-3718
Country	:	US
Telephone Number	:	702-798-0911
Fax Number	:	702-798-4723

Provider Business Practice Location Address
First Line	:	2295 RENAISSANCE DR STE C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6171
Country	:	US
Telephone Number	:	702-798-0911
Fax Number	:	702-798-0911

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/08/2007

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