MEDICARE: THOMAS WALSH M.S.P.T.

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	225100000X	Physical Therapist	19644	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	610317	OTHER	MD	BCBS MD

General Provider Information

NPI Number	:	1679593743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS WALSH M.S.P.T.

Provider Business Mailing Address
First Line	:	PO BOX 179
Second Line	:
City	:	FOREST HILL
State	:	MD
Zip	:	21050-0179
Country	:	US
Telephone Number	:	410-569-2626
Fax Number	:	410-569-7370

Provider Business Practice Location Address
First Line	:	3338 PAPER MILL RD
Second Line	:
City	:	PHOENIX
State	:	MD
Zip	:	21131-1419
Country	:	US
Telephone Number	:	443-213-0395
Fax Number	:

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	05/08/2024

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