Healthcare Provider Details

I. General information

NPI: 1871538611
Provider Name (Legal Business Name): MICHAEL JAMES WALKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 OLD LANCASTER RD SUITE 210
BRYN MAWR PA
19010
US

IV. Provider business mailing address

830 OLD LANCASTER RD SUITE 210
BRYN MAWR PA
19010-3118
US

V. Phone/Fax

Practice location:
  • Phone: 610-527-1600
  • Fax: 610-527-0824
Mailing address:
  • Phone: 610-527-1600
  • Fax: 610-527-0824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD0426261L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: