Provider Demographics
NPI:1427011980
Name:WALKER, MARSHALL WHITSON (MD)
Entity type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:WHITSON
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 FOREST LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-1916
Mailing Address - Country:US
Mailing Address - Phone:864-235-1972
Mailing Address - Fax:
Practice Address - Street 1:701 GROVE RD
Practice Address - Street 2:DEPT. OF NEONATOLOGY, GREENVILLE HOSPITAL SYSTEM
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-5611
Practice Address - Country:US
Practice Address - Phone:864-455-7939
Practice Address - Fax:864-455-3685
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0171622080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC171628Medicaid
NC7906185Medicaid
GA00777246BMedicaid
GA00777246CMedicaid