Healthcare Provider Details

I. General information

NPI: 1629039516
Provider Name (Legal Business Name): MARY A WALKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 09/30/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 ALLEGHENY RIVER BLVD
OAKMONT PA
15139-1848
US

IV. Provider business mailing address

222 ALLEGHENY RIVER BLVD
OAKMONT PA
15139-1848
US

V. Phone/Fax

Practice location:
  • Phone: 412-767-5387
  • Fax: 412-828-6642
Mailing address:
  • Phone: 412-767-5387
  • Fax: 412-828-6642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD050620L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: