MEDICARE: MCW PSYCH CARE MD, LLC

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	2084P0800X	Psychiatry Physician

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	:	1699438549
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCW PSYCH CARE MD, LLC

Provider Business Mailing Address
First Line	:	234 OLEANDER AVE APT 6
Second Line	:
City	:	PALM BEACH
State	:	FL
Zip	:	33480-3824
Country	:	US
Telephone Number	:	352-497-5920
Fax Number	:

Provider Business Practice Location Address
First Line	:	234 OLEANDER AVE APT 6
Second Line	:
City	:	PALM BEACH
State	:	FL
Zip	:	33480-3824
Country	:	US
Telephone Number	:	352-497-5920
Fax Number	:	561-629-5240

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	DR. MARK CHRISTOPHER WALKER
Credential	:	MD
Telephone Number	:	352-497-5920

Provider Enumeration Date	:	10/18/2021
Last Update Date	:	06/21/2025

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