Healthcare Provider Details

I. General information

NPI: 1386638351
Provider Name (Legal Business Name): ORRIN ABRAHAM WALKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 03/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 S MAIN ST
CHINA GROVE NC
28023-2471
US

IV. Provider business mailing address

302 S MAIN ST
CHINA GROVE NC
28023-2471
US

V. Phone/Fax

Practice location:
  • Phone: 704-857-8769
  • Fax: 704-857-8779
Mailing address:
  • Phone: 704-857-8769
  • Fax: 704-857-5779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200000656
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: