Provider Demographics
NPI:1588866933
Name:WALKER, MICHAEL DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAVID
Last Name:WALKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E MARSHALL ST STE 106
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4443
Mailing Address - Country:US
Mailing Address - Phone:610-431-2161
Mailing Address - Fax:610-431-2173
Practice Address - Street 1:600 E MARSHALL ST STE 106
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4443
Practice Address - Country:US
Practice Address - Phone:610-431-2161
Practice Address - Fax:610-431-2173
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0377011223S0112X, 122300000X
IDD-40611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice