Individual
DR. JOHN JOSEPH WALSH IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14 RICHLAND MEDICAL PARK DR STE 200, COLUMBIA, SC 29203-6882
(803) 296-7846
(803) 296-9699
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(803) 296-9699
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
18986
SC
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
18986
SC
2086S0105X
Surgery of the Hand (Surgery) Physician
18986
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0534520001
MEDICARE DME
SC
05
—
189860
—
SC
01
—
AA46323357
MEDICARE PTAN
SC
Enumeration date
04/14/2006
Last updated
09/12/2022
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