Healthcare Provider Details

I. General information

NPI: 1043491483
Provider Name (Legal Business Name): KAREN HALLERMEIER WALSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901C PEACHTREE DUNWOODY RD NE # C STE C-65
ATLANTA GA
30328-5382
US

IV. Provider business mailing address

127 CANDLER OAKS LN
DECATUR GA
30030-3771
US

V. Phone/Fax

Practice location:
  • Phone: 404-252-9751
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD426466
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number061015
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: