Doctor Name: | EDWARD J WALSH |
NPI Number: | 1003070954 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 4301092538 |
Business Practice Address: | 10850 E Traverse Hwy Ste 60 Traverse City, MI - 496841364 |
Business Phone Number: | 2319350497 |
Business Fax Number: | 2319350498 |
Mailing Address: | 10850 E Traverse Hwy, Ste 60 TRAVERSE CITY |
State: | MI |
Postal Code: | 496841364 |
Phone Number: | 2319350497 |
Fax Number: | 2319350498 |
NPI Enumeration Date: | 07/10/2008 |
NPI Last Update Date: | 05/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 4301092538 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |