MEDICARE: DR. EDWARD CHARLES WALKER 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	2085R0202X	Diagnostic Radiology Physician	35.041314	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	:	1811926389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD CHARLES WALKER M. D.

Provider Business Mailing Address
First Line	:	1675 E MAIN ST
Second Line	:	BOX 328
City	:	KENT
State	:	OH
Zip	:	44240-5818
Country	:	US
Telephone Number	:	330-593-1030
Fax Number	:	330-677-8770

Provider Business Practice Location Address
First Line	:	1675 E MAIN ST
Second Line	:	BOX 328
City	:	KENT
State	:	OH
Zip	:	44240-5818
Country	:	US
Telephone Number	:	330-593-1030
Fax Number	:	330-677-8770

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	11/10/2009

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