Provider Demographics
NPI:1194929984
Name:WALKER, HEATHER WHITT (MD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:WHITT
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1788
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29465-1788
Mailing Address - Country:US
Mailing Address - Phone:843-820-7777
Mailing Address - Fax:843-820-7757
Practice Address - Street 1:9181 MEDCOM ST
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9168
Practice Address - Country:US
Practice Address - Phone:843-820-7777
Practice Address - Fax:843-820-7757
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-003072081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5907010Medicaid
NC2007-00307OtherNC LICENSE
SC37603OtherSC STATE LICENSE
NC2068055Medicare PIN
NC2007-00307OtherNC LICENSE