Doctor Name: | DR. MICHAEL ANTHONY WALSH |
NPI Number: | 1255468054 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | |
Business Practice Address: | 9806 Grand Ave Franklin Park, IL - 601312679 |
Business Phone Number: | 8474558148 |
Business Fax Number: | 8474558136 |
Mailing Address: | 9806 Grand Ave, FRANKLIN PARK |
State: | IL |
Postal Code: | 601312679 |
Phone Number: | 8474558148 |
Fax Number: | 8474558136 |
NPI Enumeration Date: | 02/27/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |