MEDICARE: RONDI KATHLEEN WALKER MD

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	207Y00000X	Otolaryngology Physician	MD17911	DC
2	208200000X	Plastic Surgery Physician	D0041082	MD

General Provider Information

NPI Number	:	1356419824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONDI KATHLEEN WALKER MD

Provider Business Mailing Address
First Line	:	3301 NEW MEXICO AVENUE NW
Second Line	:	#252
City	:	WASHINGTON
State	:	DC
Zip	:	20016-3610
Country	:	US
Telephone Number	:	202-364-6673
Fax Number	:	202-686-0257

Provider Business Practice Location Address
First Line	:	3301 NEW MEXICO AVENUE NW
Second Line	:	#252
City	:	WASHINGTON
State	:	DC
Zip	:	20016-3610
Country	:	US
Telephone Number	:	202-364-6673
Fax Number	:	202-686-0257

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

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	07/21/2022

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