Healthcare Provider Details

I. General information

NPI: 1396364139
Provider Name (Legal Business Name): LAURA WALSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2020
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 SMITH AVE BLDG SUITE210
BALTIMORE MD
21209-3652
US

IV. Provider business mailing address

1830 E MONUMENT ST RM 9029
BALTIMORE MD
21287-0020
US

V. Phone/Fax

Practice location:
  • Phone: 410-735-7000
  • Fax:
Mailing address:
  • Phone: 410-955-7910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD600006054
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: