MEDICARE: JOAN T WALSH D P M

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	213E00000X	Podiatrist	SC002793L	PA

General Provider Information

NPI Number	:	1649406588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOAN T WALSH D P M

Provider Business Mailing Address
First Line	:	1226 LORD STERLING RD
Second Line	:
City	:	WASHINGTON CROSSING
State	:	PA
Zip	:	18977-1338
Country	:	US
Telephone Number	:	215-493-0784
Fax Number	:

Provider Business Practice Location Address
First Line	:	1226 LORD STERLING RD
Second Line	:
City	:	WASHINGTON CROSSING
State	:	PA
Zip	:	18977-1338
Country	:	US
Telephone Number	:	215-493-0784
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOAN T WALSH
Credential	:	DPM
Telephone Number	:	215-493-0784

Provider Enumeration Date	:	06/05/2009
Last Update Date	:	09/09/2020

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