Provider Demographics
NPI:1720074180
Name:WALKER, CHARLES MATTHEW (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:MATTHEW
Last Name:WALKER
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 M ST SW APT W105
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-2636
Mailing Address - Country:US
Mailing Address - Phone:202-826-6288
Mailing Address - Fax:
Practice Address - Street 1:490 M ST SW APT W105
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-2636
Practice Address - Country:US
Practice Address - Phone:202-826-6288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH100001382183500000X
MD20970183500000X
NC22955183500000X
GARPH022566183500000X
DEA1-0016082183500000X
VA02022104011835P0018X
SC011178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist