MEDICARE: MARTIN JOHN WALSH M.D.

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	208800000X	Urology Physician	35072487	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093711913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN JOHN WALSH M.D.

Provider Business Mailing Address
First Line	:	2000 JOSEPH E SANKER BLVD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-1979
Country	:	US
Telephone Number	:	513-841-7400
Fax Number	:	513-841-7402

Provider Business Practice Location Address
First Line	:	200 MEDICAL CENTER DR STE 500
Second Line	:
City	:	MIDDLETOWN
State	:	OH
Zip	:	45005-5183
Country	:	US
Telephone Number	:	513-841-7777
Fax Number	:	513-423-2004

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	02/05/2020

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