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Individual

MARTIN S WALKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6 TSIENNETO RD, DERRY, NH 03038-1584
(603) 434-7444
(603) 434-1733
Mailing address
425 BLACK WALNUT DR, MOUNTAIN TOP, PA 18707-1566
(443) 481-6538
(443) 481-6515

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
10637
NH
208600000X
Surgery Physician
MD061845L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0RE5299
VT
05
1031721820001
PA
05
3081247
NH
05
911003800
MD
Enumeration date
08/11/2006
Last updated
01/28/2022
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