Healthcare Provider Details

I. General information

NPI: 1649187949
Provider Name (Legal Business Name): WALTER NATHANIEL GAYDEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 FAIRMOUNT AVE SUITE #200 1198
TOWSON MD
21286
US

IV. Provider business mailing address

709 E. 37 ST
BALTIMORE MD
21218
US

V. Phone/Fax

Practice location:
  • Phone: 667-516-9103
  • Fax:
Mailing address:
  • Phone: 443-531-2408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: