MEDICARE: SAMUEL C WALKER NMD PC

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	175F00000X	Naturopath	97-499	AZ

General Provider Information

NPI Number	:	1558435198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMUEL C WALKER NMD PC

Provider Business Mailing Address
First Line	:	1000 E INDIAN SCHOOL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-4810
Country	:	US
Telephone Number	:	602-241-9105
Fax Number	:	602-241-9104

Provider Business Practice Location Address
First Line	:	1000 E INDIAN SCHOOL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-4810
Country	:	US
Telephone Number	:	602-241-9105
Fax Number	:	602-241-9104

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. SAMUEL C WALKER
Credential	:	RN, NMD
Telephone Number	:	602-241-9105

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	08/22/2020

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