MEDICARE: WALTER FLEMING ATHA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	D53051	MD

General Provider Information

NPI Number	:	1467417212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WALTER FLEMING ATHA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 64362
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21264-4362
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N WOLFE ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21287-0005
Country	:	US
Telephone Number	:	410-955-2280
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	02/08/2026

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