Healthcare Provider Details

I. General information

NPI: 1902244171
Provider Name (Legal Business Name): KATHERINE ANN WALKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE ANN CARLISLE M.D.

II. Dates (important events)

Enumeration Date: 06/11/2013
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6410 ROCKLEDGE DR STE 503
BETHESDA MD
20817-7822
US

IV. Provider business mailing address

10200 GRAND CENTRAL AVE STE 220
OWINGS MILLS MD
21117-4366
US

V. Phone/Fax

Practice location:
  • Phone: 301-530-1700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number0101268397
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberD0099381
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number18015
License Number StateHI
# 4
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberD0099381
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: