MEDICARE: KIMBERLY BURESH WALKER MD

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	207Q00000X	Family Medicine Physician	0101233577	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558374736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY BURESH WALKER MD

Provider Business Mailing Address
First Line	:	7493 RIGHT FLANK RD STE 400
Second Line	:	ASHCAKE FAMILY PHYSICIANS
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-3846
Country	:	US
Telephone Number	:	804-559-2916
Fax Number	:	804-559-9206

Provider Business Practice Location Address
First Line	:	7493 RIGHT FLANK RD STE 400
Second Line	:	ASHCAKE FAMILY PHYSICIANS
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-3846
Country	:	US
Telephone Number	:	804-559-2916
Fax Number	:	804-559-9206

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

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	09/10/2016

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