Healthcare Provider Details

I. General information

NPI: 1851327860
Provider Name (Legal Business Name): SIMONA WALSH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4870 YORK RD
BUCKINGHAM PA
18912-0665
US

IV. Provider business mailing address

4870 YORK RD PO BOX 665
BUCKINGHAM PA
18912-0665
US

V. Phone/Fax

Practice location:
  • Phone: 215-794-3305
  • Fax: 215-794-9642
Mailing address:
  • Phone: 215-794-3305
  • Fax: 215-794-9642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD419441
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: