Provider Demographics
NPI:1396845384
Name:WALCH, CHARLES A (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:A
Last Name:WALCH
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
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Mailing Address - Street 1:255 NORTH 4TH STREET
Mailing Address - Street 2:SUITE 2
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-1395
Mailing Address - Country:US
Mailing Address - Phone:301-334-8282
Mailing Address - Fax:301-334-8468
Practice Address - Street 1:255 NORTH 4TH STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1395
Practice Address - Country:US
Practice Address - Phone:301-334-8282
Practice Address - Fax:301-334-8468
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD47925208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
020027593OtherRAILROAD MEDICARE
PA413716OtherBC/S
236009OtherPEIA/ALLIANCE
53574001OtherCAREFIRST BC/S
MD205900200Medicaid
521113778001OtherCHAMPUS
521113778011OtherCIGNA
DC022247700OtherDC MEDICAID
521113778Other4 MOST
MDH814GAOtherBC/S
1395892OtherUMWA
260066OtherBLACK LUNG
S3300002OtherBLUE CHOICE
236009OtherUNITED HEALTH CARE
WV001708716OtherMT. STATE BC/S
WV0126344000OtherDPA
330396OtherTRIGON BC/S
236009OtherPEIA/ALLIANCE
PA413716OtherBC/S