Healthcare Provider Details

I. General information

NPI: 1700849940
Provider Name (Legal Business Name): ALYSON MARIE WALSH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALYSON MARIE AMES PA-C

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 COLLIER RD NW SUITE 300
ATLANTA GA
30309-1709
US

IV. Provider business mailing address

70 FRANCIS ST, 5TH FL, CARDIOLOGY BRIGHAM & WOMEN'S HOSPITAL - SHAPIRO BLDG
BOSTON MA
02115
US

V. Phone/Fax

Practice location:
  • Phone: 404-355-9815
  • Fax: 404-350-0529
Mailing address:
  • Phone: 857-307-1945
  • Fax: 857-307-2022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number004778
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: