Gerald Keith Walters, MS, PA-C
Physician Assistant in Baltimore, MD. Individual provider (NPI-1).
NPI number1104888015
StatusActive
Last updated in NPPESMar 7, 2023
Details
- NPI
- 1104888015
- Entity type
- Individual (NPI-1)
- Name
- Mr. Gerald Keith Walters
- Credential
- MS, PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 5, 2006
- Last updated
- Mar 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | C-00072 | MD | Yes |
| 363AS0400X | Physician Assistant, Surgical | C0000072 | MD |
Practice location
600 N. Wolfe St Blalock 544Johns Hopkins Medicine Division Of Interventional Radio
Baltimore, MD 21287-4010
Phone 410-614-6938 · Fax 410-955-0233
Mailing address
1501 Park Hill CtFallston, MD 21047
Phone 443-686-0905 · Fax 410-879-2048
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