MEDICARE: DR. LASHAWNDRA SLY 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	2080N0001X	Neonatal-Perinatal Medicine Physician	0101268885	VA
2	208000000X	Pediatrics Physician	2017-00693	NC

General Provider Information

NPI Number	:	1821416652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LASHAWNDRA SLY WALKER MD

Provider Business Mailing Address
First Line	:	322 MORCROFT LN
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-5658
Country	:	US
Telephone Number	:	757-641-1107
Fax Number	:

Provider Business Practice Location Address
First Line	:	2424 HOCK PLAZA SUITE 504
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27710-1005
Country	:	US
Telephone Number	:	919-681-6024
Fax Number	:	919-681-6065

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

Provider Enumeration Date	:	03/29/2014
Last Update Date	:	04/13/2020

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