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General NPI Number Information
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NPI Number | 1790901825
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Entity Type | Organization
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Legal Business Name | WALKER MERRICK DEVELOPMENTAL PEDIATRICS
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10630 LITTLE PATUXENT PKWY SUITE 125
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City | COLUMBIA
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State | MD
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Zip | 21044-3264
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Country | US
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Telephone | 410-995-5437
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Fax | 301-596-3364
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Provider Business Mailing Address
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Address Line | 10630 LITTLE PATUXENT PKWY SUITE 125
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City | COLUMBIA
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State | MD
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Zip | 21044-3264
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Country | US
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Telephone | 410-995-5437
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Fax | 301-596-3364
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HENRI F. WALKER MERRICK
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Credential | M.D.
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Telephone | 301-596-3363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | D0034745
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License Number State | MD
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