Provider Demographics
NPI:1811484843
Name:WALKER, BRIDGET (MD)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5693
Mailing Address - Country:US
Mailing Address - Phone:970-964-4036
Mailing Address - Fax:970-964-4038
Practice Address - Street 1:2730 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5693
Practice Address - Country:US
Practice Address - Phone:970-964-4036
Practice Address - Fax:970-964-4036
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD479052207N00000X
390200000X
CODR.0071275207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program