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NPI Code Detail

MEDICARE: MR. MARSHALL B. CRONICAN-WALKER L.M.S.W.

MEDICARE: MR. MARSHALL B. CRONICAN-WALKER L.M.S.W.
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
11041C0700XClinical Social Worker6801013731MI

General Provider Information

NPI Number : 1861505810
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARSHALL B. CRONICAN-WALKER L.M.S.W.
Provider Business Mailing Address
First Line : 105 HALL ST
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-2288
Country : US
Telephone Number : 231-935-4181
Fax Number : 231-935-4275
Provider Business Practice Location Address
First Line : 105 HALL ST
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-2288
Country : US
Telephone Number : 231-935-4181
Fax Number : 231-935-4275
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 01/16/2013

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